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Secondary central nervous system lymphoma: spectrum of morphological MRI appearances

BACKGROUND: Secondary central nervous system lymphoma (SCNSL) is a rare and aggressive disease, which is defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. According to previous reports, SCNSL presents mostly with leptomeningeal spread; however, our exp...

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Autores principales: Malikova, Hana, Burghardtova, Miroslava, Koubska, Eva, Mandys, Vaclav, Kozak, Tomas, Weichet, Jiri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856045/
https://www.ncbi.nlm.nih.gov/pubmed/29559780
http://dx.doi.org/10.2147/NDT.S157959
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author Malikova, Hana
Burghardtova, Miroslava
Koubska, Eva
Mandys, Vaclav
Kozak, Tomas
Weichet, Jiri
author_facet Malikova, Hana
Burghardtova, Miroslava
Koubska, Eva
Mandys, Vaclav
Kozak, Tomas
Weichet, Jiri
author_sort Malikova, Hana
collection PubMed
description BACKGROUND: Secondary central nervous system lymphoma (SCNSL) is a rare and aggressive disease, which is defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. According to previous reports, SCNSL presents mostly with leptomeningeal spread; however, our experience differs. In the present study, we demonstrate the diversity of magnetic resonance imaging (MRI) patterns in SCNSL. PATIENTS AND METHODS: Initial morphological MRI findings in 21 patients (10 women and 11 men with mean age 62.3±16.2 years) with SCNSL were retrospectively evaluated. All patients suffered from neurological symptoms and underwent MRI, and all cases were histologically verified. Twelve patients were treated by corticosteroids at the time of the initial MRI. RESULTS: Parenchymal lesions were present in 18 of 21 cases (85.7%), solitary meningeal infiltration was present in 1 patient (4.8%), leptomeningeal infiltration in combination with hypophyseal involvement in 1 patient (4.8%), and solitary involvement of the sixth cranial nerve (CN) was found in 1 patient (4.8%). Multiple lesions were present in 11 of 21 cases (52.4%). Diffusion restriction in all or part of the lesion was detected in 14 of 18 cases (77.8%). All parenchymal lesions had an infiltrative appearance and most enhanced homogenously (11 of 17 cases; 64.7%). A combination of parenchymal and meningeal involvement was found in 10 of 21 cases (47.6%). Infiltration of the CNs, basal ganglia, corpus callosum, and ependyma was present in 8 of 21 cases (38.1%) for each of the abovementioned structures; hypothalamic–hypophyseal axis was affected in 7 of 21 cases (33.3%). CONCLUSION: In contrast to previous reports, SCNSL presented as parenchymal disease. MRI is not sufficient for differentiation between primary and secondary CNS lymphoma.
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spelling pubmed-58560452018-03-20 Secondary central nervous system lymphoma: spectrum of morphological MRI appearances Malikova, Hana Burghardtova, Miroslava Koubska, Eva Mandys, Vaclav Kozak, Tomas Weichet, Jiri Neuropsychiatr Dis Treat Original Research BACKGROUND: Secondary central nervous system lymphoma (SCNSL) is a rare and aggressive disease, which is defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. According to previous reports, SCNSL presents mostly with leptomeningeal spread; however, our experience differs. In the present study, we demonstrate the diversity of magnetic resonance imaging (MRI) patterns in SCNSL. PATIENTS AND METHODS: Initial morphological MRI findings in 21 patients (10 women and 11 men with mean age 62.3±16.2 years) with SCNSL were retrospectively evaluated. All patients suffered from neurological symptoms and underwent MRI, and all cases were histologically verified. Twelve patients were treated by corticosteroids at the time of the initial MRI. RESULTS: Parenchymal lesions were present in 18 of 21 cases (85.7%), solitary meningeal infiltration was present in 1 patient (4.8%), leptomeningeal infiltration in combination with hypophyseal involvement in 1 patient (4.8%), and solitary involvement of the sixth cranial nerve (CN) was found in 1 patient (4.8%). Multiple lesions were present in 11 of 21 cases (52.4%). Diffusion restriction in all or part of the lesion was detected in 14 of 18 cases (77.8%). All parenchymal lesions had an infiltrative appearance and most enhanced homogenously (11 of 17 cases; 64.7%). A combination of parenchymal and meningeal involvement was found in 10 of 21 cases (47.6%). Infiltration of the CNs, basal ganglia, corpus callosum, and ependyma was present in 8 of 21 cases (38.1%) for each of the abovementioned structures; hypothalamic–hypophyseal axis was affected in 7 of 21 cases (33.3%). CONCLUSION: In contrast to previous reports, SCNSL presented as parenchymal disease. MRI is not sufficient for differentiation between primary and secondary CNS lymphoma. Dove Medical Press 2018-03-12 /pmc/articles/PMC5856045/ /pubmed/29559780 http://dx.doi.org/10.2147/NDT.S157959 Text en © 2018 Malikova et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Malikova, Hana
Burghardtova, Miroslava
Koubska, Eva
Mandys, Vaclav
Kozak, Tomas
Weichet, Jiri
Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title_full Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title_fullStr Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title_full_unstemmed Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title_short Secondary central nervous system lymphoma: spectrum of morphological MRI appearances
title_sort secondary central nervous system lymphoma: spectrum of morphological mri appearances
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856045/
https://www.ncbi.nlm.nih.gov/pubmed/29559780
http://dx.doi.org/10.2147/NDT.S157959
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