Diffuse large B-cell lymphoma in the C8 root mimicking a schwannoma: illustrative case

BACKGROUND: Primary lymphomas arising in peripheral nerves are extremely rare, with just a few case reports documented in the literature. OBSERVATIONS: The authors present the case of a 62-year-old female with C8 radiculopathy, initially suspected to have a schwannoma based on imaging but later diagnosed with primary C8 nerve root B-cell lymphoma. Following histopathological confirmation, the patient underwent 5 courses of chemotherapy, resulting in a decrease in the size of her lesion on magnetic resonance imaging. At her clinical follow-up 3 months later, her symptoms had improved. After performing a systematic review of the literature while adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines, the authors found only 3 similar cases, each with atypical presentations and treated with various chemotherapeutic agents and one of which experienced a central nervous system recurrence. LESSONS: These cases highlight the importance of early and accurate diagnosis for optimal management and long-term vigilance of primary lymphomas in the peripheral nerve. https://thejns.org/doi/10.3171/CASE24338.