Discussion on the Value of MRI in the Diagnosis of Central Nervous System Lymphoma_West China Medical Journal

Authors：

 DENGZhen-ping ¹ , RENHong-ping ² ,  LIANGNa ¹ , CHENJun-hui ¹

1. Department of Radiology, the Second People's Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;
2. Department of Radiology, the 363 Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANGNa, Email: 21516290@qq.com

Keywords：

Primary central nervous system lymphoma; Secondary central nervous system lymphoma; Magnetic resonance imaging

DOI：

10.7507/1002-0179.20150197

Video：

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Objective To investigate the value of MRI in the diagnosis of central nervous system lymphoma (CNSL). Methods We retrospectively analyzed the clinical data of 20 cases of primary CNSL (PCNSL) and 13 cases of secondary CNSL (SCNSL) from the Second People's Hospital of Chengdu and Chengdu 363 Hospital from January to December 2013, and analyzed their clinical data and MRI image data. We observed the tumor location, tumor size and signal, and carried out the statistical analysis. Results Twenty patients had PCNSL in the brain, including single lesion in 9 (45.0%), and multiple in 11 (55.0%). Among the 48 lesions, there were 23 (47.9%) nodular lesions, 21 (43.8%) crumb lesions, and 4 (8.3%) dot patch lesions; MRI showed slightly low T1 signal and slightly high T2 signal in most lesions, and showed significant even enhancing, and mild to moderate edema around the tumor. SCNSL lesions were mainly meningeal disseminated with 3 cases (23.1%) of single lesions and 10 cases (76.9%) of multiple ones, and there were a total of 30 lesions. MRI manifested that T1 and T2 mainly showed equal signals, and showed an obviously even enhancing status, and mild to moderate edema around the tumor. Conclusion The central nervous system lymphoma has a certain characteristic MRI image, and MRI images of the primary and secondary central nervous system lymphoma were similar.

Citation： DENGZhen-ping, RENHong-ping, LIANGNa, CHENJun-hui. Discussion on the Value of MRI in the Diagnosis of Central Nervous System Lymphoma. West China Medical Journal, 2015, 30(4): 688-691. doi: 10.7507/1002-0179.20150197 Copy

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4.	曹崑, 李洁, 汪宁, 等. 非原发中枢神经系统非霍奇金淋巴瘤脑实质病变影像表现分析[J]. 实用放射学杂志, 2006, 22(1):17-19.
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10.	张禹, 张龙江, 葛锐, 等. 原发性脑淋巴瘤的MRI功能成像和延迟强化特点[J]. 中国医学计算机成像杂志, 2011, 17(2):97-103.
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12.	耿承军, 陈君坤, 卢光明, 等. 原发性中枢神经系统淋巴瘤的CT、MRI表现与病理对照研究[J]. 中华放射学杂志, 2003, 37(3):246-250.
13.	高培毅, 林燕, 孙波. 原发性脑内恶性淋巴瘤的MRI研究[J]. 中华放射学杂志, 1999, 33(11):749-753.
14.	耿少梅, 焦保华, 孙晓枫. 原发性颅内恶性淋巴瘤的临床特点及影像学诊断[J]. 中华神经医学杂志, 2004, 3(3):188-190.
15.	赵芸芸, 刘剑羽, 徐辉. 淋巴瘤的磁共振弥散加权成像及其病理相关性[J]. 中国医学影像技术, 2010, 26(6):1001-1004.
16.	杨群顶, 高炬, 孙培祥, 等. 颅内淋巴瘤的影像学诊断[J]. 医学影像学杂志, 2007, 17(5):437-439.
17.	胡毅, 冯奉仪, 石远凯, 等. 原发性中枢神经系统淋巴瘤28例临床分析[J]. 中华肿瘤杂志, 2004, 26(6):375-378.
18.	Kim DS, Na DG, Kim KH, et al. Distinguishing tumefactive demyelinating lesions from glioma or central nervous system lymphoma:added value of unenhanced CT compared with conventional contrast-enhanced Mr imaging[J]. Radiology, 2009, 251(2):467-475.
19.	廖伟华, 王小宜, 黄军, 等. 颅内原发性B细胞淋巴瘤MRI表现[J]. 中国医学影像技术, 2008, 24(4):499-503.
20.	Zhang D, Hu LB, Henning TD, et al. MRI findings of primary CNS lymphoma in 26 immunocompetent patients[J]. Korean J Radiol, 2010, 11(3):269-277.

1. Guo AC, Cummings TJ, Dash RC, et al. Lymphomas and high-grade astrocytomas:comparison of water diffusibility and histologic characteristics[J]. Radiology, 2002, 224(1):177-183.
2. 关鸿志, 陈琳, 郭玉璞, 等. 脑膜淋巴瘤的临床脑脊液细胞学研究[J]. 中华神经科杂志, 2006, 39(2):113-117.
3. Gerstner ER, Batchelor TT. Primary central nervous system lymphoma[J]. Arch Neurol, 2010, 67(3):291-297.
4. 曹崑, 李洁, 汪宁, 等. 非原发中枢神经系统非霍奇金淋巴瘤脑实质病变影像表现分析[J]. 实用放射学杂志, 2006, 22(1):17-19.
5. Levin N, Soffer D, Grissaru S, et al. Primary T-cell CNS lymphoma presenting with leptomeningeal spread and neurolymphomatosis[J]. J Neurooncol, 2008, 90(1):77-83.
6. Haldoren IS, Espeland A, Larsson EM. Central nervous system lymphoma:characteristic findings on traditional and advanced imaging[J]. AJNR Am J Neuroradiol, 2011, 32(6):984-992.
7. 张海捷, 张雪林. 原发性中枢神经系统淋巴瘤的MRI表现与病理学对照研究[J]. 临床放射学杂志, 2010, 29(2):148-151.
8. Olson JE, Janney CA, Rao RD, et al. The continuing increase in the incidence of primary central nervous system non-Hodgkin lymphoma:a surveillance, epidemiology, and end results analysis[J]. Cancer, 2002, 95(7):1504-1510.
9. 陈长青, 陈晨, 陈常勇, 等. 原发性脑内恶性淋巴瘤的CT、MRI诊断[J]. 临床放射学杂志, 2004, 23(4):283-286.
10. 张禹, 张龙江, 葛锐, 等. 原发性脑淋巴瘤的MRI功能成像和延迟强化特点[J]. 中国医学计算机成像杂志, 2011, 17(2):97-103.
11. 徐胜生, 欧阳羽, 张志伟, 等. 脑内原发性淋巴瘤MRI特征[J]. 临床放射学杂志, 2011, 30(6):781-784.
12. 耿承军, 陈君坤, 卢光明, 等. 原发性中枢神经系统淋巴瘤的CT、MRI表现与病理对照研究[J]. 中华放射学杂志, 2003, 37(3):246-250.
13. 高培毅, 林燕, 孙波. 原发性脑内恶性淋巴瘤的MRI研究[J]. 中华放射学杂志, 1999, 33(11):749-753.
14. 耿少梅, 焦保华, 孙晓枫. 原发性颅内恶性淋巴瘤的临床特点及影像学诊断[J]. 中华神经医学杂志, 2004, 3(3):188-190.
15. 赵芸芸, 刘剑羽, 徐辉. 淋巴瘤的磁共振弥散加权成像及其病理相关性[J]. 中国医学影像技术, 2010, 26(6):1001-1004.
16. 杨群顶, 高炬, 孙培祥, 等. 颅内淋巴瘤的影像学诊断[J]. 医学影像学杂志, 2007, 17(5):437-439.
17. 胡毅, 冯奉仪, 石远凯, 等. 原发性中枢神经系统淋巴瘤28例临床分析[J]. 中华肿瘤杂志, 2004, 26(6):375-378.
18. Kim DS, Na DG, Kim KH, et al. Distinguishing tumefactive demyelinating lesions from glioma or central nervous system lymphoma:added value of unenhanced CT compared with conventional contrast-enhanced Mr imaging[J]. Radiology, 2009, 251(2):467-475.
19. 廖伟华, 王小宜, 黄军, 等. 颅内原发性B细胞淋巴瘤MRI表现[J]. 中国医学影像技术, 2008, 24(4):499-503.
20. Zhang D, Hu LB, Henning TD, et al. MRI findings of primary CNS lymphoma in 26 immunocompetent patients[J]. Korean J Radiol, 2010, 11(3):269-277.

West China Medical Journal

Discussion on the Value of MRI in the Diagnosis of Central Nervous System Lymphoma

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