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MRI findings of primary CNS lymphoma in 26 immunocompetent patients.

Zhang D, Hu LB, Henning TD, Ravarani EM, Zou LG, Feng XY, Wang WX, Wen L - Korean J Radiol (2010)

Bottom Line: Twenty-one cases of monofocal disease were compared to five cases of multifocal disease.The MRI features were compared between the monofocal and multifocal disease cases.Intra-tumoral calcification was not found.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing, P.R.China.

ABSTRACT

Objective: To record the MR imaging features of primary central nervous system lymphoma (PCNSL) and compare these features in monofocal and multifocal disease.

Materials and methods: Twenty-one cases of monofocal disease were compared to five cases of multifocal disease. All patients were examined by non-enhanced and contrast-enhanced MRI. Tumor location, tumor size, signal intensity, enhancement characteristics, age distribution, peritumoral edema, cystic changes, and the presence of calcifications were assessed. The MRI features were compared between the monofocal and multifocal disease cases.

Results: The 26 cases, including both the monofocal and multifocal cases, exhibited 37 lesions. Contrast-enhanced images showed variable enhancement patterns: homogeneous enhancement (33 lesions), ring-like enhancement (2), and 'open-ring-like' enhancement (2). The 'notch sign' was noted in four of 33 homogeneously enhancing lesions. One case of hemorrhage and three cases of cystic formation were observed. Intra-tumoral calcification was not found. The frontal lobe, the corpus callosum and the basal ganglia were commonly affected in both the monofocal and multifocal groups. Tumor size differed significantly between the two groups (t = 3.129, p < 0.01) and mildly or moderately enhanced lesions were more frequently found in the monofocal group (p < 0.05). There was no statistical difference between perifocal edema (p > 0.05) and the signal characteristics (p > 0.05) between the two groups.

Conclusion: Our data show that PCNSL has a variable enhancement pattern on MR images. We first reported two lesions with an 'open-ring' enhancement as well as four cases with a 'notch sign'. Monofocal PCNSL cases typically have larger sized tumors with mild or moderate enhancement.

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Images of 56-year-old woman with lymphoma involving frontal lobe bilaterally including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B) and post-contrast axial T1-weighted image (C). 'Open-ring' enhancement (arrow) was found and was characterized as thick and not uniform.
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Figure 5: Images of 56-year-old woman with lymphoma involving frontal lobe bilaterally including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B) and post-contrast axial T1-weighted image (C). 'Open-ring' enhancement (arrow) was found and was characterized as thick and not uniform.

Mentions: Monofocal lesions showed a variable contrast enhancement ranging from mild (n = 3), to moderate (n = 5), and to marked enhancement (n = 13) (Table 3). The enhancement was homogeneous in 19 cases. In three of these 19 cases, an abnormally deep depression was found at the tumor margin, which we called 'notch sign' (Figs. 1-3). A ring-like enhancement was found in two cases in which the ring was not closed and it was called 'open-ring' enhancement (Figs. 4, 5). The open-ring like enhancement was thick and not uniform.


MRI findings of primary CNS lymphoma in 26 immunocompetent patients.

Zhang D, Hu LB, Henning TD, Ravarani EM, Zou LG, Feng XY, Wang WX, Wen L - Korean J Radiol (2010)

Images of 56-year-old woman with lymphoma involving frontal lobe bilaterally including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B) and post-contrast axial T1-weighted image (C). 'Open-ring' enhancement (arrow) was found and was characterized as thick and not uniform.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864853&req=5

Figure 5: Images of 56-year-old woman with lymphoma involving frontal lobe bilaterally including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B) and post-contrast axial T1-weighted image (C). 'Open-ring' enhancement (arrow) was found and was characterized as thick and not uniform.
Mentions: Monofocal lesions showed a variable contrast enhancement ranging from mild (n = 3), to moderate (n = 5), and to marked enhancement (n = 13) (Table 3). The enhancement was homogeneous in 19 cases. In three of these 19 cases, an abnormally deep depression was found at the tumor margin, which we called 'notch sign' (Figs. 1-3). A ring-like enhancement was found in two cases in which the ring was not closed and it was called 'open-ring' enhancement (Figs. 4, 5). The open-ring like enhancement was thick and not uniform.

Bottom Line: Twenty-one cases of monofocal disease were compared to five cases of multifocal disease.The MRI features were compared between the monofocal and multifocal disease cases.Intra-tumoral calcification was not found.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, XinQiao Hospital, Third Military Medical University, ChongQing, P.R.China.

ABSTRACT

Objective: To record the MR imaging features of primary central nervous system lymphoma (PCNSL) and compare these features in monofocal and multifocal disease.

Materials and methods: Twenty-one cases of monofocal disease were compared to five cases of multifocal disease. All patients were examined by non-enhanced and contrast-enhanced MRI. Tumor location, tumor size, signal intensity, enhancement characteristics, age distribution, peritumoral edema, cystic changes, and the presence of calcifications were assessed. The MRI features were compared between the monofocal and multifocal disease cases.

Results: The 26 cases, including both the monofocal and multifocal cases, exhibited 37 lesions. Contrast-enhanced images showed variable enhancement patterns: homogeneous enhancement (33 lesions), ring-like enhancement (2), and 'open-ring-like' enhancement (2). The 'notch sign' was noted in four of 33 homogeneously enhancing lesions. One case of hemorrhage and three cases of cystic formation were observed. Intra-tumoral calcification was not found. The frontal lobe, the corpus callosum and the basal ganglia were commonly affected in both the monofocal and multifocal groups. Tumor size differed significantly between the two groups (t = 3.129, p < 0.01) and mildly or moderately enhanced lesions were more frequently found in the monofocal group (p < 0.05). There was no statistical difference between perifocal edema (p > 0.05) and the signal characteristics (p > 0.05) between the two groups.

Conclusion: Our data show that PCNSL has a variable enhancement pattern on MR images. We first reported two lesions with an 'open-ring' enhancement as well as four cases with a 'notch sign'. Monofocal PCNSL cases typically have larger sized tumors with mild or moderate enhancement.

Show MeSH
Related in: MedlinePlus