Application value of magnetic resonance imaging in diagnosing central nervous system lymphoma

OBJECTIVE: To describe the magnetic resonance imaging (MRI) appearance of central nervous system lymphoma. METHODS: We retrospectively reviewed MRI images of 40 patients who had pathologically proven primary central nervous system lymphoma (PCNSL) and received treatment in Binzhou People’s Hospital, Shandong, China from January to December in 2014. Location, size and form of tumor was observed and relevant data were recorded for analysis. RESULTS: Foci of 40 cases of PCNSL all located in brain, among which. 18 cases were single (45.0%) and 22 cases were multiple (55.5%). Of 96 Foci, 84 were supratentorial, 12 were subtentorial. Enhanced MRI scanning showed that, most Foci had significant homogenous enhancement, shaping as multiple nodular or lumpy, and few had ring-enhancement. MRI suggested that, T1 signal of most Foci concentrated on low signal segment and T2 signal gathered on high signal segment, suggesting a significant homogeneous enhancement; moreover, mild and medium edema surrounded the tumor. They were pathologically confirmed as B cell derived non-hodgkin lymphoma. Except one case of Burkitt lymphoma, the others were all diffuse large B cell lymphoma which was observed with diffuse distribution of cancer cells (little cytoplasm, large nucleus, rough perichromatin granule) in same size. Fifteen cases were observed with sleeve-like infiltration of cancer cells around blood vessels. No case was found with hemorrhage, necrosis or calcification. CONCLUSION: Pathological foundation of PCNSL determines its characteristic MRI performance. Typical case of PCNSL can be diagnosed accurately by MRI.