Central nervous system lymphoma: histologic types and CT appearance

Abstract

The distribution of histologic types of lymphoma according to the proposed working formulation was determined for 55 patients with primary central nervous system (CNS) non-Hodgkin lymphoma. Fifty-five percent of these patients had diffuse large-cell histologic features. When the relationship between histologic type and computed tomographic (CT) appearance was analyzed, the following trends were noted: A greater percentage of mixed cell tumors were multiple when compared with other types; noncleaved small-cell tumors were more commonly located in the central gray matter or corpus callosum than were other types; all immunoblastic tumors were enhanced homogeneously, unlike other types; and smaller tumors appeared to be associated with an increased histologic grade. Eleven patients had CT confirmation of a CNS recurrence; in eight patients, the recurrent tumor was in a different location than the original lesion. Eleven patients had associated intraocular lymphoma, and four were immunosuppressed.