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PT  - JOURNAL ARTICLE
AU  - Yamamoto, A.
AU  - Kikuchi, Y.
AU  - Homma, K.
AU  - O&#039;uchi, T.
AU  - Furui, S.
TI  - Characteristics of Intravascular Large B-Cell Lymphoma on Cerebral MR Imaging
AID  - 10.3174/ajnr.A2770
DP  - 2011 Dec 15
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2011/12/15/ajnr.A2770.short
4100  - http://www.ajnr.org/content/early/2011/12/15/ajnr.A2770.full
AB  - SUMMARY: IVL is characterized by a propensity for intravascular tumor cell proliferation. Premortem diagnosis of IVL is difficult because of its nonspecific clinical, laboratory, and imaging manifestations. This study examined cerebral MR imaging patterns of IVL and their changes with and without chemotherapy. Nine of 11 patients studied presented with abnormal findings. We define 5 patterns of abnormal MR imaging findings: 1) infarctlike lesions, 2) nonspecific white matter lesions, 3) meningeal enhancement, 4) masslike lesions, and 5) hyperintense lesions in the pons on T2WI. Seven patients presented with only 1 pattern, while 2 patients presented with multiple patterns. Lesions in 7 treated patients responded to chemotherapy. Pathologic specimens revealed intravascular tumor cell infiltration with associated infarctions, necrosis, congestion, demyelination, vasculitis, and tumor cell extravasation. We conclude that MR imaging patterns can be possible manifestations of intravascular-dominant infiltration by tumor cells with associated occlusion or inflammation, depending on the level of affected vessels. Abbreviations IVLintravascular large B-cell lymphomaPRESposterior reversible encephalopathy syndromeR-CHOPrituximab with cyclophosphamide, vincristine, doxorubicin, and prednisolone