Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 May-Jun;11(3):269-77.
doi: 10.3348/kjr.2010.11.3.269. Epub 2010 Apr 29.

MRI findings of primary CNS lymphoma in 26 immunocompetent patients

Dong Zhang  1 , Liang-Bo Hu, Tobias D Henning, Elisabeth M Ravarani, Li-Guang Zou, Xiao-Yuan Feng, Wen-Xian Wang, Li Wen
Affiliations

MRI findings of primary CNS lymphoma in 26 immunocompetent patients

Dong Zhang et al. Korean J Radiol. 2010 May-Jun.

Abstract

Objective: To record the MR imaging features of primary central nervous system lymphoma (PCNSL) and compare these features in monofocal and multifocal disease.

Materials and methods: Twenty-one cases of monofocal disease were compared to five cases of multifocal disease. All patients were examined by non-enhanced and contrast-enhanced MRI. Tumor location, tumor size, signal intensity, enhancement characteristics, age distribution, peritumoral edema, cystic changes, and the presence of calcifications were assessed. The MRI features were compared between the monofocal and multifocal disease cases.

Results: The 26 cases, including both the monofocal and multifocal cases, exhibited 37 lesions. Contrast-enhanced images showed variable enhancement patterns: homogeneous enhancement (33 lesions), ring-like enhancement (2), and 'open-ring-like' enhancement (2). The 'notch sign' was noted in four of 33 homogeneously enhancing lesions. One case of hemorrhage and three cases of cystic formation were observed. Intra-tumoral calcification was not found. The frontal lobe, the corpus callosum and the basal ganglia were commonly affected in both the monofocal and multifocal groups. Tumor size differed significantly between the two groups (t = 3.129, p < 0.01) and mildly or moderately enhanced lesions were more frequently found in the monofocal group (p < 0.05). There was no statistical difference between perifocal edema (p > 0.05) and the signal characteristics (p > 0.05) between the two groups.

Conclusion: Our data show that PCNSL has a variable enhancement pattern on MR images. We first reported two lesions with an 'open-ring' enhancement as well as four cases with a 'notch sign'. Monofocal PCNSL cases typically have larger sized tumors with mild or moderate enhancement.

Keywords: Brain neoplasm; Computed tomography (CT); Lymphoma; Magnetic resonance (MR).

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Images of 52-year-old man with lymphoma of left basal ganglia including plain CT image (A), axial T1-weighted image (B), T2-weighted image (C), FLAIR (D) and postcontrast axial T1-weighted image (E). Abnormally deep depression at tumor margin (notch sign) (arrow) was found on post-contrast axial T1-weighted image and plain CT image.
Fig. 2
Fig. 2
Images of 71-year-old woman with lymphoma of left temporal lobe including pre-contrast axial T1-weighted image (A), post-contrast axial T1-weighted image (B). 'Notch sign' (arrow) was found on post-contrast T1-weighted image.
Fig. 3
Fig. 3
Images of 49-year-old woman with primary central nervous system lymphoma including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B), post-contrast axial T1-weighted image (C). 'Notch sign' (arrow) was found after contrast injection.
Fig. 4
Fig. 4
Images of 57-year-old man with lymphoma of right frontal lobe including plain CT image (A), contrast CT image (B), axial T1-weighted image (C), FLAIR (D), postcontrast axial T1-weighted image (E) and sagittal T1-weighted image (F). On plain CT image; lesion was hyperdense. 'Open-ring' enhancement (arrows) was found and was characterized as thick and not uniform.
Fig. 5
Fig. 5
Images of 56-year-old woman with lymphoma involving frontal lobe bilaterally including pre-contrast axial T1-weighted image (A), pre-contrast T2-weighted image (B) and post-contrast axial T1-weighted image (C). 'Open-ring' enhancement (arrow) was found and was characterized as thick and not uniform.
See this image and copyright information in PMC

Comment in

References

    1. Gutmann J, Kendall B. Unusual appearances of primary central nervous system non-Hodgkin's lymphoma. Clin Radiol. 1994;49:696–702. - PubMed
    1. Watanabe M, Tanaka R, Takeda N, Wakabayashi K, Takahashi H. Correlation of computed tomography with the histopathology of primary malignant lymphoma of the brain. Neuroradiology. 1992;34:36–42. - PubMed
    1. Coulon A, Lafitte F, Hoang-Xuan K, Martin-Duverneuil N, Mokhtari K, Blustajn J, et al. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients. Eur Radiol. 2002;12:329–340. - PubMed
    1. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H. Pathology with clinical correlations of primary central nervous system non-Hodgkin's lymphoma. The Massachusetts General Hospital experience 1958-1989. Cancer. 1994;74:1383–1397. - PubMed
    1. Nitta T, Uda K, Ebato M, Ikezaki K, Fukui M, Sato K. Primary peripheral-postthymic T-cell lymphoma in the central nervous system: immunological and molecular approaches to diagnosis. J Neurosurg. 1995;82:77–82. - PubMed