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Primary central nervous system lymphoma: CT and pathologic correlation.

Y Y Lee, J M Bruner, P Van Tassel

    AJR. American Journal of Roentgenology
    |October 1, 1986
    PubMed
    Summary
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    CT scans reveal distinct patterns in primary central nervous system (CNS) lymphoma. AIDS patients frequently show ring enhancement, mimicking abscesses, necessitating accurate tissue diagnosis for effective treatment.

    Area of Science:

    • Neuroradiology
    • Oncology
    • Infectious Diseases

    Background:

    • Primary central nervous system (CNS) lymphoma is a rare malignancy.
    • Distinguishing CNS lymphoma from other brain lesions, such as abscesses, can be challenging on CT imaging.
    • Acquired immunodeficiency syndrome (AIDS) is associated with an increased incidence of CNS lymphoma.

    Purpose of the Study:

    • To evaluate the variable CT patterns of primary CNS lymphoma.
    • To correlate CT findings with histopathologic findings.
    • To identify differences in CT appearance between AIDS and non-AIDS patients with CNS lymphoma.

    Main Methods:

    • Retrospective review of CT findings in 15 patients with histologically proven primary CNS lymphoma.
    • Pathologic correlation of CT observations.

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  • Analysis of lesion characteristics including density, enhancement pattern, and surrounding edema.
  • Main Results:

    • Most lesions in non-AIDS patients were hyper- or isodense, round/oval masses with homogeneous enhancement and edema, showing preserved lymphoma cells without necrosis.
    • In AIDS patients, rim or ring enhancement was frequent, mimicking brain abscess, with extensive tumor necrosis and peripheral viable cells.
    • An infrequent pattern included multiple infiltrative nonnodular solid enhancements with extensive edema and infiltrating viable tumor cells.

    Conclusions:

    • CT patterns of primary CNS lymphoma vary, particularly in AIDS patients.
    • Ring-enhancing lesions in AIDS patients can represent either lymphoma or abscess, highlighting the need for tissue diagnosis.
    • Accurate diagnosis through tissue collection is crucial for appropriate treatment of CNS lymphoma.