Although meningiomas are among the most frequent intracranial tumors, primary central nervous system lymphoma represents a rare variant of extranodal non-Hodgkin-type lymphoma. Here, we report on a 73-year-old man with 2 suspicious intracerebral lesions. Combined DOTATATE PET/CT identified 1 lesion as meningioma, whereas the second lesion could not be further specified although a different meningioma was felt very unlikely. Open biopsy of this lesion confirmed the diagnosis of primary central nervous system lymphoma.