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PT  - JOURNAL ARTICLE
AU  - Jahnke, Kristoph
AU  - Schilling, Andreas
AU  - Heidenreich, Jens
AU  - Stein, Harald
AU  - Brock, Mario
AU  - Thiel, Eckhard
AU  - Korfel, Agnieszka
TI  - Radiologic Morphology of Low-Grade Primary Central Nervous System Lymphoma in Immunocompetent Patients
DP  - 2005 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2446--2454
VI  - 26
IP  - 10
4099  - http://www.ajnr.org/content/26/10/2446.short
4100  - http://www.ajnr.org/content/26/10/2446.full
SO  - Am. J. Neuroradiol.2005 Nov 01; 26
AB  - BACKGROUND AND PURPOSE: Primary central nervous system lymphomas (PCNSLs) are usually high-grade and are rarely low-grade non-Hodgkin lymphomas (NHLs). On MR imaging, PCNSLs typically present as contrast-enhancing lesions in contact with the subarachnoid space without evidence of necrosis. We evaluated the radiologic morphology and clinical characteristics of low-grade PCNSLs, hypothesizing that they may differ from high-grade PCNSLs.METHODS: Records were reviewed from 332 patients screened for inclusion in 3 multicenter prospective trials. MR imaging scans were obtained from all patients and were centrally reviewed by 2 consultant neuroradiologists.RESULTS: Ten patients (3%) with low-grade PCNSLs (7 men and 3 women; median age, 59 years; age range, 19–61 years) were identified. Four patients had one lesion, 2 patients 2 lesions, and 4 patients had multiple lesions. The following radiologic features infrequently seen in high-grade PCNSLs were found in a substantial proportion of patients: location in deep structures or spine (n=6); lack of periventricular location (n=5); hyperintensity on T2-weighted images (n=10); moderate or absent contrast enhancement (n=6); and heterogeneous contrast enhancement (n=5). In 8 patients, &amp;gt;2 of these features were present in at least one lesion, and, thus, the radiologic appearance was assessed atypical of high-grade PCNSLs. The atypical radiologic appearance in combination with atypical or mild symptoms resulted in a false or delayed diagnosis.CONCLUSION: Low-grade PCNSLs may have a variable and atypical radiologic morphology compared with high-grade PCNSLs with the risk of false or delayed diagnosis.