Advanced

AJNR - American Journal of Neuroradiology

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ghofrani, M. Articles by Wasdahl, D.A. Search for Related Content PubMed PubMed Citation Articles by Ghofrani, M. Articles by Wasdahl, D.A.

Richter Transformation of Chronic Lymphocytic Leukemia Presenting as a Dural-Based Non-Hodgkin Lymphoma Mass

M. Ghofrani^a, B. Tantiwongkosi^a, A.S. Smith^a and D.A. Wasdahl^a

^a From the Department of Radiology, Aultman Hospital, Canton, Ohio

View larger version (102K): [in this window] [in a new window]   Fig 1. Noncontrast CT scan of the brain shows a large heterogeneously attenuated dural-based mass extending across the tentorium and the calvaria.

View larger version (70K): [in this window] [in a new window]   Fig 2. Gadolinium-enhanced axial (A), sagittal (B), and coronal (C) fast spin-echo T1-weighted images (400/18/1 [TR/TE/excitations]) through the left occipital region show a large enhanced dural-based mass measuring 8.0 x 5.5 x 8.5 cm. A part of the dural tail is seen along the incisura (arrows). Laterally, the mass erodes the occipital bone and demonstrates a mass effect on the adjacent occipital lobe and cerebellum without invasion.

View larger version (79K): [in this window] [in a new window]   Fig 3. A, Bone marrow hematoxylin-eosin (H&E) 1000x (oil), bone marrow in CLL, shows replacement of normal marrow elements by sheets of small mature lymphocytes (arrows). B, Brain H&E 1000x (oil), large cell non-Hodgkin lymphoma (Richter) transformation of CLL. Note nucleoli (arrows) and mitotic figures (arrowheads).

View larger version (131K): [in this window] [in a new window]   Fig 4. Post-therapy gadolinium-enhanced axial fast spin-echo T1-weighted image (340/14/1 [TR/TE/excitations]) reveals marked reduction of the mass size with continued abnormal enhancement along the dura.