Primary central nervous system lymphoma differential diagnosis: Difference between revisions
No edit summary |
|||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Primary central nervous system lymphoma must be differentiated from secondary CNS lymphoma, [[toxoplasmosis|cerebral toxoplasmosis]], [[glioblastoma multiforme]], and [[Cerebral abscess]].<ref name=ddxofprimarycnslymphoma1>Differential diagnosis of primary central nervous system lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 17, 2016</ref> | |||
==Differentiating Primary Central Nervous System Lymphoma from other Diseases== | ==Differentiating Primary Central Nervous System Lymphoma from other Diseases== | ||
Revision as of 19:36, 17 February 2016
|
Primary central nervous system lymphoma Microchapters |
|
Differentiating Primary Central Nervous System Lymphoma from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Primary central nervous system lymphoma differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Primary central nervous system lymphoma differential diagnosis |
|
FDA on Primary central nervous system lymphoma differential diagnosis |
|
CDC on Primary central nervous system lymphoma differential diagnosis |
|
Primary central nervous system lymphoma differential diagnosis in the news |
|
Blogs on Primary central nervous system lymphoma differential diagnosis |
|
Directions to Hospitals Treating Primary central nervous system lymphoma |
|
Risk calculators and risk factors for Primary central nervous system lymphoma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Primary central nervous system lymphoma must be differentiated from secondary CNS lymphoma, cerebral toxoplasmosis, glioblastoma multiforme, and Cerebral abscess.[1]
Differentiating Primary Central Nervous System Lymphoma from other Diseases
Primary central nervous system lymphoma must be differentiated from:[1]
- Secondary CNS lymphoma: indistinguishable on imaging, however it tends to involve more leptomeninges (~2/3 of cases)
- Cerebral toxoplasmosis
- Glioblastoma multiforme (butterfly glioma)
- Tumefactive demyelinating lesion
- Cerebral abscess
- Neurosarcoidosis
It is a relatively common occurrence for radiologists to be asked to distinguish between cerebral toxoplasmosis and primary central nervous system lymphoma in patients with HIV/AIDS. Treatment is clearly different and thus accurate interpretation of CT and MRI is essential.[2] In many instances appearances are classic and pose little problem, however, in 50-80% of cases the appearances can be very similar requiring careful interpretation. Below are helpful distinguishing features.[2]
| Differentiating point | Primary CNS Lymphoma | Cerebral Toxoplasmosis |
|---|---|---|
| Characteristics of lesion | Single lesion with subependymal spread | Multiple lesions scattered though basal ganglia and corticomedullary junction |
| Enhancement on CT and MRI | Solid enhancement, however primary CNS lymphoma patients with HIV/AIDS may demonstrate ring enhancement also. | Ring or nodular enhancement |
| Hemorrhage | No hemorrhage before treatment | Hemorrhage occasionally occurs mostly in periphery of lesion |
| Single-photon emission computed tomography (SPECT) | Thallium SPECT positive | Thallium SPECT negative |
| Magnetic resonance spectroscopy (MRS) | MRS: markedly increased choline (Cho) | MRS: decreased Cho |
| Magnetic resonance perfusion | MR perfusion: increased relative cerebral blood volume (rCBV) | MR perfusion: decreased rCBV |
References
- ↑ 1.0 1.1 Differential diagnosis of primary central nervous system lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 17, 2016
- ↑ 2.0 2.1 Toxoplasmosis vs CNS lymphoma. Dr Henry Knipe and Dr Praveen Jha et al. Radiopaedia 2016. http://radiopaedia.org/articles/toxoplasmosis-vs-lymphoma. Accessed on February 17, 2016