Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
نویسندگان
چکیده
Background Secondary central nervous system lymphoma (SCNSL) is a rare and aggressive disease, which is defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. According to previous reports, SCNSL presents mostly with leptomeningeal spread; however, our experience differs. In the present study, we demonstrate the diversity of magnetic resonance imaging (MRI) patterns in SCNSL. Patients and methods Initial morphological MRI findings in 21 patients (10 women and 11 men with mean age 62.3±16.2 years) with SCNSL were retrospectively evaluated. All patients suffered from neurological symptoms and underwent MRI, and all cases were histologically verified. Twelve patients were treated by corticosteroids at the time of the initial MRI. Results Parenchymal lesions were present in 18 of 21 cases (85.7%), solitary meningeal infiltration was present in 1 patient (4.8%), leptomeningeal infiltration in combination with hypophyseal involvement in 1 patient (4.8%), and solitary involvement of the sixth cranial nerve (CN) was found in 1 patient (4.8%). Multiple lesions were present in 11 of 21 cases (52.4%). Diffusion restriction in all or part of the lesion was detected in 14 of 18 cases (77.8%). All parenchymal lesions had an infiltrative appearance and most enhanced homogenously (11 of 17 cases; 64.7%). A combination of parenchymal and meningeal involvement was found in 10 of 21 cases (47.6%). Infiltration of the CNs, basal ganglia, corpus callosum, and ependyma was present in 8 of 21 cases (38.1%) for each of the abovementioned structures; hypothalamic-hypophyseal axis was affected in 7 of 21 cases (33.3%). Conclusion In contrast to previous reports, SCNSL presented as parenchymal disease. MRI is not sufficient for differentiation between primary and secondary CNS lymphoma.
منابع مشابه
Autoimmune Hemolytic Anemia preceding the Diagnosis of Primary Central Nervous System Lymphoma
In this study, a 2.5-year-old boy suffering from a febrile seizure with normal laboratory tests and a history of immune hemolytic anemia was examined. Brain MRI demonstrated some tumors in the frontal, parietal, and occipital lobe that corroborated the pathology results of primary central nervous system lymphoma for the patient. The patient was treated with high- dose of Methotrexate. Our re...
متن کاملCentral Nervous System Burkitt Lymphoma in a child (A case report).
Introduction: Burkitt lymphoma (BL) is rare, but an aggressive malignancy. Central nervous system Burkitt lymphoma (CNSBL) is very rare. CNS Burkitt’s lymphoma is treated with high-dose chemotherapy and radiation. Radiotherapy in children younger than three years old may cause major CNS damage. Case report: A three-year-old boy presented with painful proptosis of the left eye. He under...
متن کاملEvolution of Neurolymphomatosis to Lymphomatosis Cerebri
Dear Editor, Primary central nervous system lymphoma (PCNSL), which is typically of B-cell lymphocytic origin, normally remains confined to the brain, spinal cord, and/or eyes, rarely spreading outside the nervous system. The appearance of a homogeneously enhancing periventricular rounded mass in MRI is suggestive of the diagnosis in an immunocompetent host. The case reported here illustrates a...
متن کاملNonenhancing secondary central nervous system lymphoma.
Central nervous system (CNS) lymphoma is an aggressive neoplasm. Incidence is increasing, partly due the use of immunosuppressive drugs and AIDS-related immunodeficiency. Nonenhancing lesions in CNS lymphoma are very rare, and often cause diagnostic delay. We report a case of nonenhancing secondary CNS lymphoma. We present a 77-year old man with a medical history of nine attacks of transient pa...
متن کامل