Korean Journal of Radiology

  • 제11권3호
  • /
  • Pages.269-277
  • /
  • 2010
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

MRI Findings of Primary CNS Lymphoma in 26 Immunocompetent Patients

  • Zhang, Dong (Department of Radiology, XinQiao Hospital, Third Military Medical University) ;
  • Hu, Liang-Bo (Department of Radiology, The Second People's Hospital of ChongQing) ;
  • Henning, Tobias D. (Department of Radiology, Technical University Munich) ;
  • Ravarani, Elisabeth M. (Department of Radiology, Technical University Munich) ;
  • Zou, Li-Guang (Department of Radiology, XinQiao Hospital, Third Military Medical University) ;
  • Feng, Xiao-Yuan (Department of Radiology, HuaShan Hospital, Medical Center of FuDan University) ;
  • Wang, Wen-Xian (Department of Radiology, XinQiao Hospital, Third Military Medical University) ;
  • Wen, Li (Department of Radiology, XinQiao Hospital, Third Military Medical University)
  • 투고 : 2009.08.07
  • 심사 : 2009.12.08
  • 발행 : 2010.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

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 nonenhanced 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.

키워드

참고문헌

  1. Gutmann J, Kendall B. Unusual appearances of primary central nervous system non-Hodgkin's lymphoma. Clin Radiol 1994;49:696-702 https://doi.org/10.1016/S0009-9260(05)82663-7
  2. Watanabe M, Tanaka R, Takeda N, Wakabayashi K, Takahashi H. Correlation of computed tomography with the histopathology of primary malignant lymphoma of the brain. Neuroradiology 1992;34:36-42 https://doi.org/10.1007/BF00588431
  3. Coulon A, Lafitte F, Hoang-Xuan K, Martin-Duverneuil N, Mokhtari K, Blustajn J, et al. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients. Eur Radiol 2002;12:329-340 https://doi.org/10.1007/s003300101037
  4. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H. Pathology with clinical correlations of primary central nervous system non-Hodgkin's lymphoma. The Massachusetts General Hospital experience 1958-1989. Cancer 1994;74:1383- 1397. https://doi.org/10.1002/1097-0142(19940815)74:4<1383::AID-CNCR2820740432>3.0.CO;2-1
  5. Nitta T, Uda K, Ebato M, Ikezaki K, Fukui M, Sato K. Primary peripheral-postthymic T-cell lymphoma in the central nervous system: immunological and molecular approaches to diagnosis. J Neurosurg 1995;82:77-82 https://doi.org/10.3171/jns.1995.82.1.0077
  6. Slone HW, Blake JJ, Shah R, Guttikonda S, Bourekas EC. CT and MRI findings of intracranial lymphoma. AJR Am J Roentgenol 2005;184:1679-1685 https://doi.org/10.2214/ajr.184.5.01841679
  7. Jack CR Jr, Reese DF, Scheithauer BW. Radiographic findings in 32 cases of primary CNS lymphoma. AJR Am J Roentgenol 1986;146:271-276 https://doi.org/10.2214/ajr.146.2.271
  8. Jack CR Jr, O'Neill BP, Banks PM, Reese DF. Central nervous system lymphoma: histologic types and CT appearance. Radiology 1988;167:211-215 https://doi.org/10.1148/radiology.167.1.3279454
  9. Johnson BA, Fram EK, Johnson PC, Jacobowitz R. The variable MR appearance of primary lymphoma of the central nervous system: comparison with histopathologic features. AJNR Am J Neuroradiol 1997;18:563-572
  10. Kuker W, Nagele T, Korfel A, Heckl S, Thiel E, Bamberg M, et al. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients. J Neurooncol 2005;72:169-177
  11. Jenkins CN, Colquhoun IR. Characterization of primary intracranial lymphoma by computed tomography: an analysis of 36 cases and a review of the literature with particular reference to calcification haemorrhage and cyst formation. Clin Radiol 1998;53:428-434 https://doi.org/10.1016/S0009-9260(98)80271-7
  12. Onda K, Wakabayashi K, Tanaka R, Takahashi H. Intracranial malignant lymphomas: clinicopathological study of 26 autopsy cases. Brain Tumor Pathol 1999;16:29-35 https://doi.org/10.1007/BF02478899
  13. Bataille B, Page P. Prognostic factors and primary cerebral lymphoma. Neurochirurgie 1997;43:385-387 [French]
  14. Dubuisson A, Kaschten B, Le′nelle J, Martin D, Robe P, Fassotte MF, et al. Primary central nervous system lymphoma report of 32 cases and review of the literature. Clin Neurol Neurosurg 2004;107:55-63 https://doi.org/10.1016/j.clineuro.2004.03.005
  15. Herrlinger U, Schabet M, Bitzer M, Petersen D, Krauseneck P. Primary central nervous system lymphoma: from clinical presentation to diagnosis. J Neurooncol 1999;43:219-226 https://doi.org/10.1023/A:1006298201101
  16. Erdag N, Bhorade RM, Alberico RA, Yousuf N, Patel MR. Primary lymphoma of the central nervous system: typical and atypical CT and MR imaging appearances. AJR Am J Roentgenol 2001;176:1319-1326 https://doi.org/10.2214/ajr.176.5.1761319
  17. Gliemroth J, Kehler U, Gaebel C, Arnold H, Missler U. Neuroradiological findings in primary cerebral lymphomas of non-AIDS patients. Clin Neurol Neurosurg 2003;105:78-86 https://doi.org/10.1016/S0303-8467(02)00105-1
  18. Cellerier P, Chiras J, Gray F, Metzger J, Bories J. Computed tomography in primary lymphoma of the brain. Neuroradiology 1984;26:485-492 https://doi.org/10.1007/BF00342686
  19. Hochberg FH, Miller DC. Primary central nervous system lymphoma. J Neurosurg 1988;68:835-853 https://doi.org/10.3171/jns.1988.68.6.0835
  20. Holodny AI, Nusbaum AO, Festa S, Pronin IN, Lee HJ, Kalnin AJ. Correlation between the degree of contrast enhancement and the volume of peritumoral edema in meningiomas and malignant gliomas. Neuroradiology 1999;41:820-825 https://doi.org/10.1007/s002340050848
  21. Koeller KK, Smirniotopoulos JG, Jones RV. Primary central nervous system lymphoma: radiologic-pathologic correlation. Radiographics 1997;17:1497-1526 https://doi.org/10.1148/radiographics.17.6.9397461
  22. Brown JH, Stallmeyer MJ, Lustrin ES, Chew FS. Primary cerebral lymphoma. AJR Am J Roentgenol 1995;165:626 https://doi.org/10.2214/ajr.165.3.7645482
  23. Reni M, Ferreri AJ, Garancini MP, Villa E. Therapeutic management of primary central nervous system lymphoma in immunocompetent patients: results of a critical review of the literature. Ann Oncol 1997;8:227-234 https://doi.org/10.1023/A:1008201717089
  24. Schabet M. Epidemiology of primary CNS lymphoma. J Neurooncol 1999;43:199-201 https://doi.org/10.1023/A:1006290032052
  25. Jiddane M, Nicoli F, Diaz P, Bergvall U, Vincentelli F, Hassoun J, et al. Intracranial malignant lymphoma. Report of 30 cases and review of the literature. J Neurosurg 1986;65:592-599 https://doi.org/10.3171/jns.1986.65.5.0592
  26. Thomas M, MacPherson P. Computed tomography of intracranial lymphoma. Clin Radiol 1982;33:331-336 https://doi.org/10.1016/S0009-9260(82)80283-3
  27. DeAngelis LM. Cerebral lymphoma presenting as a nonenhancing lesion on computed tomographic/magnetic resonance scan. Ann Neurol 1993;33:308-311
  28. Terae S, Ogata A. Nonenhancing primary central nervous system lymphoma. Neuroradiology 1996;38:34-37 https://doi.org/10.1007/BF00593213
  29. Braks E, Urbach H, Pels H, Traber F, Block W, Schild HH. Primary central nervous system immunocytoma: MRI and spectroscopy. Neuroradiology 2000;42:738-741 https://doi.org/10.1007/s002340000392
  30. Masdeu JC, Quinto C, Olivera C, Tenner M, Leslie D, Visintainer P. Open-ring imaging sign: highly specific for atypical brain demyelination. Neurology 2000;54:1427-1433 https://doi.org/10.1212/WNL.54.7.1427
  31. Bizzi A, Movsas B, Tedeschi G, Phillips CL, Okunieff P, Alger JR, et al. Response of non-Hodgkin lymphoma to radiation therapy: early and long-term assessment with H-1 MR spectroscopic imaging. Radiology 1995;194:271-276 https://doi.org/10.1148/radiology.194.1.7997566

피인용 문헌

  1. Correspondence Re: MRI Findings of Primary CNS Lymphoma in 26 Immunocompetent Patients vol.11, pp.6, 2010, https://doi.org/10.3348/kjr.2010.11.6.702
  2. Imaging of primary central nervous system lymphoma vol.66, pp.8, 2010, https://doi.org/10.1016/j.crad.2011.03.006
  3. Neuroradiological Viewpoint on the Diagnostics of Space-Occupying Brain Lesions vol.21, pp.3, 2010, https://doi.org/10.1007/s00062-011-0073-6
  4. An Approach to Improve the Diagnosis of Primary CNS Lymphoma Using Conventional and Advanced Imaging Techniques vol.35, pp.21, 2010, https://doi.org/10.1097/01.cdr.0000421911.46844.dd
  5. Central nervous system lymphoma: magnetic resonance imaging features at presentation. vol.70, pp.2, 2010, https://doi.org/10.1590/s0004-282x2012000200005
  6. Primary Central Nervous System Lymphoma vol.14, pp.2, 2010, https://doi.org/10.1007/s11864-013-0227-7
  7. A Case of Primary T-Cell Central Nervous System Lymphoma: MR Imaging and MR Spectroscopy Assessment vol.2013, pp.None, 2010, https://doi.org/10.1155/2013/916348
  8. Neuroimaging of Primary Central Nervous System Lymphoma in Immunocompetent Patients: Comparison of Recent and Previous Findings vol.80, pp.3, 2013, https://doi.org/10.1272/jnms.80.174
  9. Primary Central Nervous System Lymphoma: A Clinicopathological and Cytomorpholgical Study from A Tertiary Care Centre in Chennai, India vol.14, pp.2, 2013, https://doi.org/10.7314/apjcp.2013.14.2.727
  10. Differentiation of primary central nervous system lymphoma from high-grade glioma and brain metastases using susceptibility-weighted imaging vol.4, pp.6, 2010, https://doi.org/10.1002/brb3.288
  11. Imaging of Brain Tumors vol.23, pp.4, 2010, https://doi.org/10.1016/j.soc.2014.07.004
  12. Primary central nervous system lymphoma: is absence of intratumoral hemorrhage a characteristic finding on MRI? vol.49, pp.2, 2010, https://doi.org/10.1515/raon-2015-0007
  13. A rare case of nonenhancing primary central nervous system lymphoma mimic multiple sclerosis vol.20, pp.4, 2015, https://doi.org/10.17712/nsj.2015.4.20150125
  14. Primary diffuse large B-cell lymphoma of the central nervous system: A case report and literature review vol.11, pp.5, 2010, https://doi.org/10.3892/ol.2016.4365
  15. Modern techniques of magnetic resonance in the evaluation of primary central nervous system lymphoma: contributions to the diagnosis and differential diagnosis vol.38, pp.1, 2010, https://doi.org/10.1016/j.bjhh.2015.12.001
  16. Linfoma primario del sistema nervioso central: el aporte de las técnicas convencionales de diagnóstico por imágenes vol.80, pp.2, 2010, https://doi.org/10.1016/j.rard.2015.10.007
  17. Primary central nervous system lymphoma: essential points in diagnosis and management vol.34, pp.4, 2010, https://doi.org/10.1007/s12032-017-0920-7
  18. Glioblastoma multiforme presenting with an open ring pattern of enhancement on MR imaging vol.8, pp.1, 2010, https://doi.org/10.4103/sni.sni_35_17
  19. Secondary Central Nerve System Lymphoma With Intratumoral Hemorrhage Suggested as Intravascular Lymphoma by Autopsy: A Case Report vol.9, pp.11, 2010, https://doi.org/10.14740/jocmr3177w
  20. Primary central nervous system lymphoma: Retrospective analysis of 34 cases in a single centre vol.46, pp.2, 2018, https://doi.org/10.1177/0300060517734395
  21. Critical revision of the role of surgery for treatment of primary brain b cell lymphoma in an immunocompetent patient: a case report and literature review vol.8, pp.2, 2010, https://doi.org/10.15406/jnsk.2018.08.00288
  22. Clival Chondrosarcoma Associated With an Intra-Axial Cystic Medullary Lesion Responsive to Steroids vol.9, pp.None, 2018, https://doi.org/10.3389/fneur.2018.00502
  23. Myriad of MR imaging phenotypes of primary central nervous system lymphoma in a cohort of immunocompetent Indian patient population vol.28, pp.3, 2010, https://doi.org/10.4103/ijri.ijri_23_18
  24. Apparent diffusion coefficient value for a B-cell central nervous system lymphoma in a cat vol.4, pp.1, 2018, https://doi.org/10.1177/2055116917750762
  25. A Case of Sarcoidosis-lymphoma Syndrome: Importance of Brain Biopsy vol.6, pp.2, 2010, https://doi.org/10.2176/nmccrj.cr.2018-0223
  26. Specific Features of Primary Central Nervous System Lymphoma in Comparison with Glioblastoma on Conventional MRI vol.16, pp.1, 2019, https://doi.org/10.5812/iranjradiol78868
  27. Guidelines for the diagnosis and management of primary central nervous system diffuse large B‐cell lymphoma vol.184, pp.3, 2019, https://doi.org/10.1111/bjh.15661
  28. Imaging features (CT, MRI, MRS, and PET/CT) of primary central nervous system lymphoma in immunocompetent patients vol.40, pp.3, 2010, https://doi.org/10.1007/s10072-018-3669-7
  29. Traditional and Advanced Neuroimaging Contributions to the Diagnosis and Differential Diagnosis of Central Nervous System Lymphoma Patients Visiting a Comprehensive Medical Center vol.13, pp.1, 2010, https://doi.org/10.2174/1874440002013010006
  30. Conventional MR and DW imaging findings of cerebellar primary CNS lymphoma: comparison with high-grade glioma vol.10, pp.None, 2010, https://doi.org/10.1038/s41598-020-67080-9
  31. Performance of diffusion and perfusion MRI in evaluating primary central nervous system lymphomas of different locations vol.20, pp.1, 2010, https://doi.org/10.1186/s12880-020-00462-7
  32. Primary Central Nervous System T-cell Lymphoma as Methotrexate-associated Lymphoproliferative Disorders: Case Report vol.8, pp.1, 2010, https://doi.org/10.2176/nmccrj.cr.2020-0234
  33. CXCL13 and CXCL9 CSF Levels in Central Nervous System Lymphoma-Diagnostic, Therapeutic, and Prognostic Relevance vol.12, pp.None, 2010, https://doi.org/10.3389/fneur.2021.654543
  34. Treatment Regimens for Immunocompetent Elderly Patients with Primary Central Nervous System Lymphoma: A Scoping Review vol.13, pp.17, 2010, https://doi.org/10.3390/cancers13174268