Keywords:
Neuroradiology brain, MR, Computer Applications-Detection, diagnosis, Cancer
Authors:
A. Saiz1, C. Suárez Arcay1, D. Villegas2, L. MartÃnez3, E. Santamarta1, J. Peña Suarez3, �. Meilán MartÃnez1, F. Arias1; 1Oviedo/ES, 2Zacatecas/MX, 3Gijón/ES
DOI:
10.26044/ecr2019/C-3793
Conclusion
Although initially bony changes may be minimal, in advances cases,
typical radiographic images show a large soft tissue component of the permeative growth or a moth-eaten pattern and less cortical destruction.
On plain CT scan and MRI,
these lesions are iso-hyperdense and isointense in nature,
respectively,
with homogeneous enhancement after contrast administration.
Hypointensity on T2 an low ADC values, when present,
are a helpul distinguishing feature reflecting its hypercellular nature.
Bone window CT is better in assessing cortical bone involvement but contrast MRI is superior in showing diffuse primary cutaneous invasion of the cranial vault and it is also more accurate for evaluating bone marrow and brain surface invasion.
As in CNS lymphoma we found a low rCBV with a T1-dominant contrast leakage pattern. So perfusion weighted image may be helpful in the diagnosis of calvarial lymphoma distinguish it from metastases or meningiomas.
The differential diagnosis of calvarial NHL includes other soft tissue masses as metastatic cancer,
leukemia,
plasmacytoma,
anaplastic meningioma and sarcoidosis.
Ewing sarcoma and Langerhan cell histiocytosis usually occurs in younger patients and can also mimic calvaria lymphoma. Relative absence of cortical destruction favours lymphoma over other bony neoplasms .