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Magnetic resonance features of primary central nervous system lymphoma in the immunocompetent patient: A pictorial essay
Author(s) -
Yap Kelvin K,
Sutherland Tom,
Liew Elaine,
Tartaglia Con J,
Pang Mei,
Trost Nick
Publication year - 2012
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02345.x
Subject(s) - medicine , primary central nervous system lymphoma , stereotactic biopsy , lymphoma , magnetic resonance imaging , radiology , biopsy , central nervous system , cerebrospinal fluid , brain biopsy , calcification , pathology
Summary Primary central nervous system lymphoma (PCNSL) is an uncommon but important variant of non‐Hodgkin lymphoma and represents up to 6% of all primary central nervous system (CNS) malignancies. Recognition of this entity by radiologist on MRI may avoid unnecessary neurosurgical resection and redirect to biopsy. The pretreatment MRI of patients with biopsy proven PCNSL from the last 5 years at our institution was reviewed. Selected examples were used to construct a pictorial essay to illustrate some of the typical and atypical MR features of PCNSL. MRI of other CNS conditions with imaging similarities to PCNSL was included to demonstrate possible mimics. The typical features of PCNSL lymphoma are intra‐axial homogenous single or multiple contrast enhancing lesions, with marked surrounding oedema and restricted diffusion, usually contacting a cerebrospinal fluid (CSF) surface. Necrosis, peripheral enhancement, haemorrhage or calcification are unusual and other diagnoses should be considered if any of these features are present. Potential mimics include high grade glioma, infarcts, metastatic disease, demyelination, abscess and secondary lymphoma. Careful assessment of the MR features and correlation with the clinical findings should enable the radiologists to raise the possibility of PCNSL and minimise the risk of unnecessary resection.