RT Journal Article
SR Electronic
T1 Characteristics of Intravascular Large B-Cell Lymphoma on Cerebral MR Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 292
OP 296
DO 10.3174/ajnr.A2770
VO 33
IS 2
A1 A. Yamamoto
A1 Y. Kikuchi
A1 K. Homma
A1 T. O'uchi
A1 S. Furui
YR 2012
UL http://www.ajnr.org/content/33/2/292.abstract
AB SUMMARY: IVL is characterized by a propensity for intravascular tumor cell proliferation. Premortem diagnosis of IVL is difficult because of its nonspecific clinical, laboratory, and imaging manifestations. This study examined cerebral MR imaging patterns of IVL and their changes with and without chemotherapy. Nine of 11 patients studied presented with abnormal findings. We define 5 patterns of abnormal MR imaging findings: 1) infarctlike lesions, 2) nonspecific white matter lesions, 3) meningeal enhancement, 4) masslike lesions, and 5) hyperintense lesions in the pons on T2WI. Seven patients presented with only 1 pattern, while 2 patients presented with multiple patterns. Lesions in 7 treated patients responded to chemotherapy. Pathologic specimens revealed intravascular tumor cell infiltration with associated infarctions, necrosis, congestion, demyelination, vasculitis, and tumor cell extravasation. We conclude that MR imaging patterns can be possible manifestations of intravascular-dominant infiltration by tumor cells with associated occlusion or inflammation, depending on the level of affected vessels. IVLintravascular large B-cell lymphomaPRESposterior reversible encephalopathy syndromeR-CHOPrituximab with cyclophosphamide, vincristine, doxorubicin, and prednisolone