Central nervous system lymphoma: histologic types and CT appearance

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Primary central nervous system (CNS) non-Hodgkin lymphoma (NHL) is a rare malignancy.
• Understanding the relationship between histologic subtypes and imaging characteristics is crucial for diagnosis and management.

Purpose of the Study:

• To determine the distribution of histologic types of primary CNS NHL based on the working formulation.
• To analyze the correlation between specific histologic subtypes and their computed tomographic (CT) appearance.
• To investigate patterns of CNS recurrence and associated factors.

Main Methods:

• Histologic classification of lymphoma using the proposed working formulation for 55 patients.
• Analysis of computed tomographic (CT) scans to correlate imaging features with histologic subtypes.
• Review of clinical data for CNS recurrence, intraocular involvement, and immunosuppression.

Main Results:

• Diffuse large-cell histology was observed in 55% of primary CNS NHL cases.
• Specific CT appearance trends were noted: mixed cell tumors were more frequently multiple; noncleaved small-cell tumors favored central gray matter/corpus callosum location; immunoblastic tumors showed homogeneous enhancement; smaller tumors correlated with higher histologic grade.
• CNS recurrence was confirmed in 11 patients, with eight showing new lesion locations. Associated intraocular lymphoma was present in 11 patients, and four were immunosuppressed.

Conclusions:

• Histologic subtype significantly influences the CT appearance of primary CNS non-Hodgkin lymphoma.
• The findings provide insights into the behavior and imaging characteristics of different primary CNS NHL subtypes.
• Further research may refine diagnostic and therapeutic strategies for this patient population.