Ces radiol. 2014, 68(1):64-68

Brain lymphomas, imaging characteristicOriginal article

Radek Tupý¹, Jiří Ferda¹, Jan Kastner¹, Hynek Mírka¹, Samuel Vokurka²

¹ Klinika zobrazovacích metod LF UK a FN, Plzeň

² Hematologicko-onkologické oddělení LF UK a FN, Plzeň

Aim: To revise and verify imaging methods characteristics of clinically significant and relatively rare brain lymphomas.

Methods: Retrospective analysis of CT and MR imaging methods results in patients with brain lymphoma diagnosed in 2001-2013 at our university hospital.

Results: 30 patients with median age of 60 (24-82) years were analysed. CT were performed in 25/30, MR in 24/30 patients, and 20 CT and 21 MR were available for retrospective revision. The primary and isolated brain lymphoma (histologically non-hodgkin Difuse Large B-cell Lymphoma) was defined in 22/30 (73%) patients, in the others the systemic Non-Hodgkin lymphoma (4/30) or isolated relapse (4/30) were present. Median number of NHL lesions was one (1-8), in one case there were tens of lesions present. Median diameter of the lesions was 28 × 30 × 29 (11 × 16 × 20 to 85 × 76 × 65) mm. The fundamental finding in brain lymphoma MR imaging was lesion with marked contrast enhancement, predominantly homogenous, diffusion restriction and large collateral oedema with minimal expantion. Only in 2 out of 16 patients with lumbar puncture, lymphoma presence in fluid was detected.

Conclusion: When specifying brain focal lesions on MR, it is necessary to consider lymphoma etiology and to elect imaging protocols with contrast agents and diffusion weighted sequence. Imaging methods and biopsy should be performed prior to start of corticosteroid therapy, as this modifies the characteristics of the lesions.

Keywords: lymphoma, brain, magnetic resonance imaging

Accepted: January 20, 2014; Published: March 1, 2014  Show citation