[Neuroimaging findings in intravascular malignant lymphomatosis]

We reviewed the neuroimaging studies of five patients with intravascular malignant lymphomatosis (IML). All five patients had cerebral symptoms and three had spinal cord or root symptoms. Initial brain CTs, in two patients at the onset of cerebral symptoms, were normal. Brain MR imaging, conducted in four patients during the course of IML, showed multiple white matter lesions which were hyperintense on T2-weighted images. Some of the lesions involved cerebral cortices, and some had mass effect. Serial MR imaging was performed in three patients, and the lesions decreased in size during steroid or CHOP therapy. Gd-DTPA-enhanced study which was conducted in one patient demonstrated enhancement of the white matter lesions. Review of the literature revealed various CT or MR findings; single or multiple cortical or subcortical lesions with or without mass effect, periventricular lesions, and spinal cord lesions. Lesions may or may not be enhanced. Because neuroimaging findings are non-specific, correct diagnosis is difficult to make by imaging studies alone. One should always consider the possibility of IML in the interpretation of radiological images.