What does a fall to the ground hide? An atypical onset of follicular B-cell lymphoma

Follicular B-cell lymphoma is an indolent B-cell non-Hodgkin lymphoma, typically associated with favorable long-term outcomes and extended survival when diagnosed early. This lymphoma predominantly presents with lymphadenopathy and bone marrow involvement, while central nervous system infiltration remains exceptionally rare, and it has been reported in a few cases. Here, we present a peculiar case of follicular B-cell lymphoma with an unusual neurological onset due to meningeal involvement. Moreover, we studied the histologic expression of the disease in the three different anatomical sites involved: lymph nodes, bone marrow, and dura mater. Due to the paucity of literature data on this topic, we believe that this clinical case should be worthy of attention to help physicians when dealing with differential diagnosis in patients with neurological symptoms.