Secondary Central Nervous System Lymphoma: An Iconographic Essay.

Congress:

ECR 2020

Poster Number:

C-13544

Type:

Educational Exhibit

Keywords:

Performed at one institution, Observational, Retrospective, Lymphoma, Haematologic diseases, Cancer, Education, Comparative studies, MR, CT, Oncology, Haematologic, CNS, Oncologic Imaging

Authors:

V. Simonini, J. Albuquerque, R. Costa, H. Santos de Souza, M. F. Uberti, M. Decnop, F. Miraldi; rio de janeiro/BR

DOI:

10.26044/ecr2020/C-13544

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-13544

Fig. 2: Male, 55 years old, HIV positive with retroperitoneal high grade diffuse large...

Fig. 1: 63 years old female, with high grade diffuse large B cell lymphoma, presenting...

Fig. 3: 32 years-old female, HIV-positive with Burkitt’s lymphoma, presenting with...

Fig. 4: 25 years-old male with high grade diffuse large B cell lymphoma. Axial T1 SE FS...

Learning objectives

To demonstrate magnetic resonance imaging (MRI) findings in patients with secondary central nervous system (CNS) lymphoma.

Background

CNS involvement by lymphomas is a rare and severe condition first described in 1870 that may present in two forms: primary and secondary. The first is less common and more frequently seen in immunocompromised patients, occurring when there is just CNS lymphomatous disease - which includes brain parenchyma, meninges, spinal cord and/or eyes. In the most common secondary form, CNS lymphoma occurs either before or after multisystemic involvement. In Hodgkin lymphoma, dissemination to the CNS is uncommon and usually represents late manifestation of disseminated disease....

Findings and procedure details

CNS lymphomas usually present as parenchymal masses, cavernous sinus disease or as a result of meningeal dissemination. The latter manifests through cranial nerves, brain, spinal cord and/or spinal roots marginal (leptomeningeal) infiltration. In facial lymphomas, another type of involvement may be seen: direct perineural spread. The imaging modality of choice for secondary CNS lymphoma diagnosis is gadolinium enhanced MRI, which shows both meningeal seeding and parenchymal masses with more sensitivity than contrast enhanced computed tomography (CT), nowadays rarely used for this purpose. However, even with...

Conclusion

Although rare, secondary CNS lymphoma has a reserved prognosis, especially in advanced cases. An early diagnosis is important and requires the radiologist to have knowledge of the different patterns of lymphomatous dissemination.

Personal information and conflict of interest

V. R. F. Simonini; Rio de Janeiro/BR -Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest. E-mail: [email protected] J. Albuquerque; Rio de Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest.E-mail: [email protected] R. Costa; Rio de Janeiro, TO/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest.E-mail: [email protected] M. F. Uberti; Rio De Janeiro/BR - Radiology resident from INCA, Rio de Janeiro, Brazil. No conflict of interest.E-mail: [email protected] H. Santos de Souza; Rio...

References

Abalo-Lojo, Jose M.; Gonzalez, Francisco; Pereiro-Zabala, Inmaculada. Metastatic B-cell lymphoma of the cecum masquerading as Tolosa-Hunt syndrome. Canadian Journal Of Ophthalmology, [s.l.], v. 42, n. 2, p.323-325, abr. 2007. Elsevier BV. Barreira Junior, Alan Kardec; Moura, Frederico Castelo; Monteiro, Mario Luiz Ribeiro. Linfoma não-Hodgkin bilateral do seio cavernoso como manifestação inicial da síndrome de imunodeficiência adquirida: relato de caso. Arquivos Brasileiros de Oftalmologia, [s.l.], v. 74, n. 2, p.130-131, abr. 2011. FapUNIFESP (SciELO). Haldorsen, I.s.; Espeland, A.; Larsson, E.-m.. Central Nervous System Lymphoma: Characteristic Findings...