A clinical research on imaging and pathological features of primary central nervous system lymphoma

Abstract

Objective To investigate the clinical features, imaging and pathological characteristics of primary central nervous system lymphoma (PCNSL) in order to increase the diagnostic accuracy of PCNSL in clinic. Methods A retrospective analysis of 6 cases with PCNSL confirmed by pathological and immunohistochemical examination, treated in our hospital from December 2013 to August 2014 was performed. The clinical presentations, lesion locations, imaging manifestations and histopathological features were analysed.  Results The symptoms were various, among which headache and dizziness were frequently presented. Five cases were identified to have solitary tumor foci and the other one had multiple lesions. Among 7 lesions, 4 were located in cerebral hemisphere, one was located in cerebellum, one in lateral ventricle and one in thalamus. Moreover, 2 lesions were involved in corpus callosum. The lesions presented in roundish shape or irregular shape with clear boundary, minimal edema and mass effect. CT showed high-density of the lesions. All lesions showed iso- or slightly hypo-intense signal on T₁WI and iso- or mild hyper-intense on T₂WI, and homogeneous enhancement after contrast. All cases underwent operations. The tumors appeared flesh red or grey-white, soft and without capsules. Under microscopic examination, the tumor cells were distributed around the blood vessels as "sleeve-like" infiltration. Immune phenotype analysis showed all tumors were B-cell lymphoma.  Conclusions PCNSL has certain imaging and pathological features and most of them are diffuse large B-cell lymphoma (DLBCL). Pathological examination and immune phenotype analysis are "gold standard" in making confirmed diagnosis.

DOI: 10.3969/j.issn.1672-6731.2016.11.014