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Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients

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Abstract

To avoid an unnecessary extend of surgery in primary central nervous system lymphoma (PCNSL), the diagnosis should be suspected after MRI.

Pre-treatment MRI examinations of 100 immunologically competent patients with biopsy-proven PCNSL were evaluated. All patients had T2- and T1-weighted images with contrast enhancement. Diffusion-weighted MRI (DW-MRI) was available in 15, proton-MR-spectroscopy (1H-MRS) in four patients.

The number of lesions ranged from one (n=65 patients) to eight (n=1) with a mean of 1.7. The most frequent locations were the cerebral hemispheres (n=66), the basal ganglia (n=27) and the corpus callosum (n=24). In the 65 patients with a solitary lesion, hemispheric lesions were most frequent (n=23) followed by corpus callosum (n=18). Contrast enhancement was found in all but one patient. 1H-MRS revealed a uniformly pathologic pattern of metabolite concentrations in all patients.

Characteristic imaging features of PCNSL are contrast-enhancing lesions with a diameter of at least 15 mm in contact with the subarachnoid space. DW-MRI and proton spectroscopy may aid in differential diagnosis.

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Author notes

  1. Wilhelm Küker

    Present address: Department of Neuroradiology, Radcliffe Infirmary, Woodstock Road, Oxford, OX2 6HE, UK

Authors and Affiliations

  1. Department of Neuroradiology, Medical School, University of Tübingen, Tübingen, Germany

    Wilhelm Küker, Thomas Nägele & Stefan Heckl

  2. Dep-artment of Neurology, Medical School, University of Tübingen, Tübingen, Germany

    Michael Weller & Ulrich Herrlinger

  3. Department of Radiation Oncology, Medical School, University of Tübingen, Tübingen, Germany

    Michael Bamberg

  4. Department of Hematology and Oncology, University Hospital Benjamin Franklin, Berlin, Germany

    Agnieska Korfel & Eckhard Thiel

  5. Department of Neuroradiology, The Radcliffe Infirmary, Woodstock Road, Oxford, OX2 6HE, UK

    Wilhelm Küker

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  1. Wilhelm Küker
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  2. Thomas Nägele
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  3. Agnieska Korfel
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  7. Michael Weller
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  8. Ulrich Herrlinger
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Correspondence to Wilhelm Küker.

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Küker, W., Nägele, T., Korfel, A. et al. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients. J Neurooncol 72, 169–177 (2005). https://doi.org/10.1007/s11060-004-3390-7

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  • DOI: https://doi.org/10.1007/s11060-004-3390-7

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