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Related Experiment Videos

Primary central nervous system lymphoma presenting as diffuse cerebral infiltration

T Furusawa1, K Okamoto, J Ito

  • 1Department of Radiology, School of Medicine, Niigata University, Japan.

Radiation Medicine
|July 3, 1998
PubMed
Summary

This case study highlights primary central nervous system lymphoma (PCNSL) mimicking gliomatosis cerebri on MRI. Brain biopsy is crucial for diagnosing diffuse, non-enhancing brain lesions, leading to effective treatment.

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Area of Science:

  • Neurology
  • Radiology
  • Oncology

Background:

  • Primary central nervous system lymphoma (PCNSL) can present with diffuse cerebral infiltration.
  • Magnetic Resonance Imaging (MRI) is a key diagnostic tool for brain lesions.

Observation:

  • A case of PCNSL showed high signal intensity lesions on T2-weighted MRI, primarily in the pyramidal tracts, with diffuse white matter involvement and brain swelling.
  • No contrast enhancement was observed after Gadolinium-DTPA administration.
  • Radiological diagnosis suggested gliomatosis cerebri due to the characteristic MRI findings.

Findings:

  • Stereotactic biopsy confirmed diffusely scattered neoplastic lymphocytes in the cerebral white matter.
  • The patient showed a dramatic clinical improvement following oral corticosteroids, radiation therapy, and chemotherapy.

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  • Post-treatment MRI revealed significant regression of lesions and reduced brain swelling.

    • Implications:

    • Brain biopsy is essential for accurate diagnosis of diffuse, non-enhancing brain lesions.
    • Early diagnosis and multimodal treatment (corticosteroids, radiation, chemotherapy) can lead to favorable outcomes in PCNSL.
    • MRI findings in PCNSL can mimic other conditions, underscoring the need for histopathological confirmation.