RT Journal Article
SR Electronic
T1 Radiologic Morphology of Low-Grade Primary Central Nervous System Lymphoma in Immunocompetent Patients
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2446
OP 2454
VO 26
IS 10
A1 Jahnke, Kristoph
A1 Schilling, Andreas
A1 Heidenreich, Jens
A1 Stein, Harald
A1 Brock, Mario
A1 Thiel, Eckhard
A1 Korfel, Agnieszka
YR 2005
UL http://www.ajnr.org/content/26/10/2446.abstract
AB BACKGROUND AND PURPOSE: Primary central nervous system lymphomas (PCNSLs) are usually high-grade and are rarely low-grade non-Hodgkin lymphomas (NHLs). On MR imaging, PCNSLs typically present as contrast-enhancing lesions in contact with the subarachnoid space without evidence of necrosis. We evaluated the radiologic morphology and clinical characteristics of low-grade PCNSLs, hypothesizing that they may differ from high-grade PCNSLs.METHODS: Records were reviewed from 332 patients screened for inclusion in 3 multicenter prospective trials. MR imaging scans were obtained from all patients and were centrally reviewed by 2 consultant neuroradiologists.RESULTS: Ten patients (3%) with low-grade PCNSLs (7 men and 3 women; median age, 59 years; age range, 19–61 years) were identified. Four patients had one lesion, 2 patients 2 lesions, and 4 patients had multiple lesions. The following radiologic features infrequently seen in high-grade PCNSLs were found in a substantial proportion of patients: location in deep structures or spine (n=6); lack of periventricular location (n=5); hyperintensity on T2-weighted images (n=10); moderate or absent contrast enhancement (n=6); and heterogeneous contrast enhancement (n=5). In 8 patients, >2 of these features were present in at least one lesion, and, thus, the radiologic appearance was assessed atypical of high-grade PCNSLs. The atypical radiologic appearance in combination with atypical or mild symptoms resulted in a false or delayed diagnosis.CONCLUSION: Low-grade PCNSLs may have a variable and atypical radiologic morphology compared with high-grade PCNSLs with the risk of false or delayed diagnosis.