Primary cerebral lymphoma has varied clinical and imaging presentations making the neuroradiologic diagnosis of primary cerebral lymphoma a challenge. We discuss here three cases of cerebral lymphoma, one primary and two secondary. Our aim is to highlight the importance of diffusion, perfusion and spectroscopy in addition to conventional morphological MRI, and the role of stereotactic biopsy in reaching a correct diagnosis.
JackCRO'NeillBP: Central nervous system lymphoma: Histologic types and CT appearance. Radiology167: 211–215, 1988.
6.
RussellDSRubisteinLJ: Pathology of the tumours of nervous system, 5th ed.William and Wilkins, Baltimore1989.
7.
DeckertMPaulusW: Malignant lymphomas, WHO Classification of Tumours of the Central Nervous System, 4th Edition: 188–196, International Agency for Research on Cancer2007.
8.
AtlasSW: Magnetic Resonance Imaging of the brain and spine. Intra axial brain tumours: 302 – 307. Raven Press, New York1991.
9.
GuoACCummingsTJ: Lymphoma and high grade astrocytomas: Comparision of water diffusibility and histologic characteristics. Radiology: 177–83, 2002.
10.
HToh CCastilloM: Primary Cerebral Lymphoma and Glioblastoma Multiforme: Differences in Diffusion Characteristics Evaluated with Diffusion Tensor Imaging. Am J Neuroradiology2: 471–75, Mar 2008.
11.
RollinNGuyotatJ: Clinical relevance of diffusion and perfusion magnetic resonance imaging in assessing intra-axial brain tumours. Neuroradiology48: 150–159 DOI 10.1007/s00234-005-0030-7, 2006.
12.
BruhnH: Non invasive differentiation of tumours with use of localised H-1 MRI spectroscopy in vivo: Initial experience in patients with cerebral tumours. Radiology: 541–8, 1989.
13.
ButzenJProstRChettyV: Discrimination between neoplastic and non neoplastic brain lesions by use of Proton MRI spectroscopy. The limits of accuracy with Logistic Regression Model. Am Soc Neuroradiology: 1213–9, 2000.
14.
Al-OkailiRNKrejzaJWangS: Advanced MR imaging techniques in the diagnosis of intra axial brain tumours in adults. Radiographics: 173–89, 2005.
15.
KuhlmannTSchroterA: Diagnosis of a multifocal B cell lymphoma with preceding demyelinating central nervous system lesions by single voxel proton MR spectroscopy. J Neurol Neurosurgery Psychiatry70: 259–262, 2001.
16.
AkerFVHakanT: Accuracy and diagnostic yield of stereotactic biopsy in the diagnosis of brain masses: Comparision of results of biopsy and resected surgical specimens. Neuropathology25: 207–213, 2005.
17.
JacksonRJNFuller G: Limitations of stereotactic biopsy in the initial management of gliomas. Neuro-Oncology: 193–200, July 2001.
18.
AHall W: The Safety and Efficacy of Stereotactic Biopsy for Intracranial Lesions. Cancer: 1749–1755, May 1998.
19.
AHall WLiuH: Comparision of Stereotactic brain biopsy to Interventional Magnetic – Resonance-Imaging-Guided Brain Biopsy. Stereotactic and Functional Neurosurgery73: 148–153, 1999.
20.
Cha: Intracranial Mass Lesions: Dynamic Contrast – enhanced Susceptibility – weighted Echo – planar perfusion MR imaging. Radiology223 Number 1: 11–29, April 2002.