Comparative study among MR imaging and pathological findings in primary central nervous system lymphoma

LU Fangxiao; LIU Lulu; YANG Jiantao

Abstract：Objective To explore the MRI imaging features of primary central nervous system lvmphoma (PCNSL) so as to improve the knowledge and diagnostic accuracy of this disease. Methods The MRI imagings and clinical data of 18 patients with PCNSL,who had been confirmed by surgery and pathology,were retrospectively reviewed. Results 18 patients included 7 cases with a single lesion and 11 cases with multiple lesions,11 cases included 25 lesions totally. 32 lesions of PCNSLs all growed focally, 17 lesions were located in the deep brain areas near the central line structure,11 lesions were located in the shallow brain region,4 large lesions were both located in the deep brain areas near the central line structure and in the shallow brain region. Corpus callosum were involved by 7 lesions,6 lesions were followed by leptomeningeal and the distance between lesion and leptomeningeal was less than 5 mm of 8 lesions. On MRI images,all lesions were almost hypointense slightly or isointense on T1-weighted MRI and isointense or hypointense slightly on T2-weighted MRI images. All lesions presented as hyperintense on DWI and hypointense on ADC obviously. Contrast-enhanced MRI images showed obvious homogenous enhancement with various shapes such as notch sign (19 cases) ,indentation sign (16 cases) ,crack sign (7 cases) ,and fist sign (3 cases) ,horseshoe sign (5 cases) ,corner sign (26 cases) ,butterfly sign (7 cases) ,and satellite sign (5 cases). Pathological studies confirmed all cases were diffuse large B-cell lymphoma. Conclusion PCNSL has certain characteristic MRI imaging findings,MRI is helpful to diagnose PCNSL.