• Tingting Yu, Jibo Yin, Hongyue Huo, Haixue Zhao, Zhongwen Wang, and Jianxin Jiang.
• Graduate School of Dalian Medical University, Lvshunkou Kou District, Dalian, Liaoning, China.
• Medicine (Baltimore). 2022 Aug 5; 101 (31): e30012e30012.

RationaleSubdural anaplastic large-cell lymphoma (SALCL) is an extremely rare subtype of primary central nervous system (CNS) lymphoma. Here, we report a very rare subdural lymphoma case, which was misdiagnosed as a subacute epidural hematoma based on the radiological examination.Patient ConcernsWe present the case of an 82-year-old patient who presented with a 2-day history of headache and consciousness disorder following head injury. Computed tomography of the head revealed a fusiform isodense/slightly dense shadow under the right temporoparietal occipital cranial plate, suggesting a subacute epidural hematoma. It was initially misdiagnosed as a right traumatic subacute epidural hematoma with hemiplegia of the left limb. According to the patient's condition, an emergency craniotomy was performed to remove the hematoma. However, it was found that the lesion was located under the dura mater and was yellowish-brown with yellowish-brown liquid inside. The appearance of the lesion looked like bean curd residue. Histopathological examination diagnosed ALCL.DiagnosisSALCL presenting as a subacute epidural hematoma on imaging.InterventionsOperation.OutcomesThe patient died 1 month after being discharged automatically.ConclusionsThis report shows a rare radiography presentation of SALCL. SALCL can mimic the appearance of an epidural hematoma and should be regarded as a differential diagnosis even in patients with a history of craniocerebral injury and the "typical" imaging appearance of an epidural hematoma. The report is hoped to provide a scientific reference for the clinical diagnosis of subdural lymphoma.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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