Diffusion tensor images and magnetic resonance spectroscopy in primary central nervous system T-cell lymphoma: a case report.
OBJECTIVE
Primary central nervous system lymphoma (PCNSL) is rare and usually B cell in origin. T-cell lymphoma constitutes only 1.8% to 4.6% of the PCNSL, and may present as solitary or multiple homogeneous enhanced lesions. There have been few reports showing unusual leukoencephalopathy in PCNSL, which may be confused with other white matter diseases including multiple sclerosis and acute disseminated encephalomyelitis.


METHODS
We reported a patient with T-cell PCNSL who presented a progressive dull response and extrapyramidal symptoms. Brain magnetic resonance imaging showed multiple focal leukoencephalopathy. Diffusion weighted imaging demonstrated hyper-intensity lesions and apparent diffusion coefficient images showed hypo-intensity lesions. Diffuse tensor images showed decreased fractional anisotropy. Pathology examination finally confirmed T-cell lymphoma.


CONCLUSIONS
Although recent development of neuro-imaging studies, the diagnosis of PCNSL still await further pathological confirmation in some occasions.
Department of Neurology, Chang Gung University, Taiwan.
Ming-Feng
MF
Liao
Cheng-Hong
CH
Toh
Hung-Chou
HC
Kuo
Chen-Che
CC
Chu
Shih-Ming
SM
Jung
Chin-Chang
CC
Huang
D016880:Anisotropy; D018951:Antigens, CD20 / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology; D017252:CD3 Complex / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged
D018951:Antigens, CD20; D017252:CD3 Complex; D002794:Choline