title: Central nervous system lymphoma: a morphological MRI study.
abstract: OBJECTIVE
  The aim of the present study was to evaluate morphological MRI findings in histologically-proven central nervous system lymphoma (CNSL) at time of their first appearance, and to describe dynamic changes on repeat MRI before the diagnosis was histologically proven.
  
  
  METHODS
  We retrospectively evaluated the MRI examinations of 74 patients with histologically-proven CNSL (10 secondary CNSL, 64 primary PCNSL; 10 immunocompromised, 54 immunocompetent). In 43 patients, we evaluated the evolution of CNSL on MRI before the diagnosis was proven.
  
  
  RESULTS
  Primary CNSL was typically localized supratentorially (63%), with multiple (59%) or infiltrative (36%) lesions showing diffusion restriction (98%), often (87%) reaching the brain surface. In approximately 50% of patients, meningeal, ependymal or cranial nerve involvement was found. We detected significant differences in enhancement patterns between immunocompromised and immunocompetent patients; non-homogenous enhancement present in 50% of immunocompromised patients. We did not find any significant differences in MRI appearance between primary and secondary CNSL. Regression was evident after corticosteroid treatment in 52% of patients; however, in 16% of cases overall progression was observed.
  
  
  CONCLUSIONS
  CNSL generally presents as an infiltrative lesion or multiple homogenously-enhancing lesions of the brain in contact with the brain surface. Involvement of the corpus callosum, cranial nerves, ependyma or meninges is common. No significant differences between primary and secondary CNSL were detected, however differences in enhancement type between immunocompromised and immunocompetent primary CNSL patients were found. We stress the variability of MRI findings in the course of the disease and also the variable response to corticotherapy.
authors.affiliation: Department of Radiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Koubska
authors.affiliation: Department of Radiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Weichet
authors.affiliation: Department of Radiology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Malikova
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D007121:Immunocompetence / Q000276:immunology; D016867:Immunocompromised Host / Q000276:immunology; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones