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Conventional and Advanced Imaging Features of CNS Intravascular Lymphoma
Sunpob Cheewadhanaraks1,2, Otto Rapalino1
1Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Summary
Intravascular lymphoma (IVL) of the central nervous system (CNS) often presents with infarct-like lesions on MRI. Advanced imaging like DSC perfusion and FDG PET showed limited diagnostic utility in this rare lymphoma subtype.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Intravascular lymphoma (IVL) is a rare, aggressive lymphoma subtype.
- Diagnosis is challenging due to nonspecific clinical presentation.
- CNS involvement in IVL requires specific diagnostic considerations.
Purpose of the Study:
- Evaluate imaging findings of CNS IVL.
- Assess the diagnostic potential of advanced imaging techniques: DSC perfusion, MRS, and FDG PET.
Main Methods:
- Retrospective analysis of 21 pathologically confirmed CNS IVL cases.
- Review of brain MRI, T2* imaging, and noninvasive angiographic imaging.
- Limited use of DSC perfusion, MRS, and FDG PET.
Main Results:
- Intracranial imaging findings present in 90% of patients.
- Most common MRI pattern: infarct-like lesions (68%).
- Other findings include mass-like enhancement, white matter changes, vascular irregularity, and spinal involvement.
Conclusions:
- Infarct-like lesions are the most common imaging finding in CNS IVL.
- Awareness of diverse imaging features is crucial for diagnosis.
- Advanced techniques like DSC perfusion and FDG PET had limited diagnostic yield in this cohort.
