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      Characteristics of Intravascular Large B-Cell Lymphoma on Cerebral MR Imaging

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          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.

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          Author and article information

          Journal
          AJNR Am J Neuroradiol
          AJNR Am J Neuroradiol
          ajnr
          ajnr
          AJNR
          AJNR: American Journal of Neuroradiology
          American Society of Neuroradiology
          0195-6108
          1936-959X
          February 2012
          : 33
          : 2
          : 292-296
          Affiliations
          [1] aFrom the Department of Radiology (A.Y., S.F.), Teikyo University School of Medicine, Tokyo, Japan
          [2] bDepartment of Radiology (Y.K., T.O.), Kameda Medical Center, Chiba, Japan
          [3] cDepartment of Pathology (K.H.), Dokkyo University School of Medicine, Tochigi, Japan.
          Author notes
          Please address correspondence to Asako Yamamoto, MD, Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan, 2-11-1, Kaga, Itabashiku, Tokyo, Japan; e-mail: asakonemurinomori@ 123456yahoo.co.jp
          Article
          PMC7964814 PMC7964814 7964814 11-00278
          10.3174/ajnr.A2770
          7964814
          22173763
          00bb754d-8a75-45f7-90ce-182e7747528a
          © 2012 by American Journal of Neuroradiology
          History
          : 1 March 2011
          : 11 May 2011
          Categories
          Brain
          Clinical Report

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