Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients.
To avoid an unnecessary extend of surgery in primary central nervous system lymphoma (PCNSL), the diagnosis should be suspected after MRI. Pre-treatment MRI examinations of 100 immunologically competent patients with biopsy-proven PCNSL were evaluated. All patients had T2- and T1-weighted images with contrast enhancement. Diffusion-weighted MRI (DW-MRI) was available in 15, proton-MR-spectroscopy (1H-MRS) in four patients. The number of lesions ranged from one (n=65 patients) to eight (n=1) with a mean of 1.7. The most frequent locations were the cerebral hemispheres (n=66), the basal ganglia (n=27) and the corpus callosum (n=24). In the 65 patients with a solitary lesion, hemispheric lesions were most frequent (n=23) followed by corpus callosum (n=18). Contrast enhancement was found in all but one patient. 1H-MRS revealed a uniformly pathologic pattern of metabolite concentrations in all patients. Characteristic imaging features of PCNSL are contrast-enhancing lesions with a diameter of at least 15 mm in contact with the subarachnoid space. DW-MRI and proton spectroscopy may aid in differential diagnosis.
Küker
Wilhelm
W
Department of Neuroradiology, Medical School, University of Tübingen, Tübingen, Germany. wilhelm. kueker@orh.nhs.uk
Nägele
Thomas
T
Korfel
Agnieska
A
Heckl
Stefan
S
Thiel
Eckhard
E
Bamberg
Michael
M
Weller
Michael
M
Herrlinger
Ulrich
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D016543:Central Nervous System Neoplasms / Q000175:diagnosis*; D005123:Eye / Q000473:pathology*; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology*