Intravascular malignant lymphomatosis: diffusion-weighted magnetic resonance imaging characteristics

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Intravascular malignant lymphomatosis (IML) is a rare neoplastic disorder characterized by the proliferation of lymphoma cells within small blood vessels.
• This condition primarily affects the central nervous system (CNS), leading to potential vascular occlusion and ischemic events.
• Early diagnosis is challenging due to its rarity and nonspecific symptoms.

Observation:

• A 68-year-old woman presented with neurological deficits.
• Magnetic resonance imaging (MRI) was performed to investigate the cause of her symptoms.
• The imaging focused on the brain and thoracic spinal cord.

Findings:

• Diffusion-weighted MRI revealed a characteristic subacute infarction pattern in the cerebral deep white matter.
• Specific findings included bright high signal intensity on b = 1000 s/mm2 images and intermediate apparent diffusion coefficient values.
• The intravascular malignant lymphomatosis involved both the cerebral white matter and the thoracic spinal cord.

Implications:

• This case highlights the utility of diffusion-weighted MRI in diagnosing intravascular malignant lymphomatosis.
• Recognizing these specific MRI patterns can aid in earlier detection and treatment of this rare condition.
• Further research into the pathogenesis and optimal management of CNS intravascular lymphoma is warranted.