Primary central nervous system lymphoma CT: Difference between revisions
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==Overview== | ==Overview== | ||
Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include [[Supratentorial|supratentorial]] hyperattenuating, enhancing, hemorrhaging mass with subependymal extension crossing the [[corpus callosum]]. | Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include [[Supratentorial|supratentorial]] hyperattenuating, enhancing, hemorrhaging mass with subependymal extension crossing the [[corpus callosum]]. Chest, abdomen, and pelvic CT scans may be used to exclude any occult systemic disease from the spread of primary central nervous system lymphoma. | ||
==Head CT== | ==Head CT== | ||
*Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include:<ref name=radiographicfeaturesofprimarycnslymphoma1>Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | *Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include:<ref name="radiographicfeaturesofprimarycnslymphoma1">Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref><ref name="diagnpstoicsprimarycnslymphoma1">Diagnostics of primary CNS lymphoma. National cancer institute 2016. http://www.cancer.gov/types/lymphoma/hp/primary-cns-lymphoma-treatment-pdq. Accessed on February 19, 2016</ref> | ||
:*[[Supratentorial|Supratentorial mass]] with subependymal extension | :*[[Supratentorial|Supratentorial mass]] with subependymal extension | ||
:*Crossing the [[corpus callosum]] | :*Crossing the [[corpus callosum]] | ||
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:*Multiple lesions in patients with HIV/AIDS | :*Multiple lesions in patients with HIV/AIDS | ||
*Enhancement on both CT scan and MRI is pronounced and usually '''homogeneous'''. Even with larger lesions, there is little mass effect for size and limited surrounding vasogenic [[edema]]. | *Enhancement on both CT scan and MRI is pronounced and usually '''homogeneous'''. Even with larger lesions, there is little mass effect for size and limited surrounding vasogenic [[edema]]. | ||
*Low grade tumors differ from the more common high-grade primary central nervous system lymphoma in several ways:<ref name=radiographicfeaturesofprimarycnslymphoma1>Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | *Low grade tumors differ from the more common high-grade primary central nervous system lymphoma in several ways:<ref name="radiographicfeaturesofprimarycnslymphoma1">Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | ||
:*Deep locations and spinal involvement is more common | :*Deep locations and spinal involvement is more common | ||
:*Contrast enhancement is absent, irregular, or only mild | :*Contrast enhancement is absent, irregular, or only mild | ||
*Disseminated meningeal/intraventricular disease is uncommon, it is observed in 5% of cases at presentation and usually in high grade cases.<ref name=radiographicfeaturesofprimarycnslymphoma1>Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | *Disseminated meningeal/intraventricular disease is uncommon, it is observed in 5% of cases at presentation and usually in high grade cases.<ref name="radiographicfeaturesofprimarycnslymphoma1">Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | ||
*It should be noted that in patients who are immunocompromised (typically HIV/AIDS or post-transplant), enhancement is more heterogeneous.<ref name=radiographicfeaturesofprimarycnslymphoma1>Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | *It should be noted that in patients who are immunocompromised (typically HIV/AIDS or post-transplant), enhancement is more heterogeneous.<ref name="radiographicfeaturesofprimarycnslymphoma1">Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016</ref> | ||
===Gallery=== | ===Gallery=== | ||
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==Chest, Abdomen, and Pelvic CT== | ==Chest, Abdomen, and Pelvic CT== | ||
*Chest, abdomen, and pelvic CT scans may be used to exclude any occult systemic disease from the spread of primary central nervous system lymphoma.<ref name=diagnpstoicsprimarycnslymphoma1>Diagnostics of primary CNS lymphoma. National cancer institute 2016. http://www.cancer.gov/types/lymphoma/hp/primary-cns-lymphoma-treatment-pdq. Accessed on February 19, 2016</ref> | *Chest, abdomen, and pelvic CT scans may be used to exclude any occult systemic disease from the spread of primary central nervous system lymphoma.<ref name="diagnpstoicsprimarycnslymphoma1">Diagnostics of primary CNS lymphoma. National cancer institute 2016. http://www.cancer.gov/types/lymphoma/hp/primary-cns-lymphoma-treatment-pdq. Accessed on February 19, 2016</ref> | ||
==References== | ==References== | ||
Latest revision as of 17:22, 20 May 2019
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Primary central nervous system lymphoma Microchapters |
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Differentiating Primary Central Nervous System Lymphoma from other Diseases |
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Primary central nervous system lymphoma CT On the Web |
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American Roentgen Ray Society Images of Primary central nervous system lymphoma CT |
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Directions to Hospitals Treating Primary central nervous system lymphoma |
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Risk calculators and risk factors for Primary central nervous system lymphoma CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include supratentorial hyperattenuating, enhancing, hemorrhaging mass with subependymal extension crossing the corpus callosum. Chest, abdomen, and pelvic CT scans may be used to exclude any occult systemic disease from the spread of primary central nervous system lymphoma.
Head CT
- Head CT scan may be helpful in the diagnosis of primary central nervous system lymphoma. Findings on CT scan suggestive of primary central nervous system lymphoma include:[1][2]
- Supratentorial mass with subependymal extension
- Crossing the corpus callosum
- Lesions are hyperattenuating (70%)
- Enhancement present
- Hemorrhage is distinctly present
- Multiple lesions in patients with HIV/AIDS
- Enhancement on both CT scan and MRI is pronounced and usually homogeneous. Even with larger lesions, there is little mass effect for size and limited surrounding vasogenic edema.
- Low grade tumors differ from the more common high-grade primary central nervous system lymphoma in several ways:[1]
- Deep locations and spinal involvement is more common
- Contrast enhancement is absent, irregular, or only mild
- Disseminated meningeal/intraventricular disease is uncommon, it is observed in 5% of cases at presentation and usually in high grade cases.[1]
- It should be noted that in patients who are immunocompromised (typically HIV/AIDS or post-transplant), enhancement is more heterogeneous.[1]
Gallery
-
![Single image from a non-contrast CT scan demonstrating a vague bilateral hyperdensity crossing the midline.[3]](/images/d/df/Ct_image_primary_central_nervous_system_lymphoma_image_1.jpg)
Single image from a non-contrast CT scan demonstrating a vague bilateral hyperdensity crossing the midline.[3]
![Single image from a non-contrast CT scan demonstrating a vague bilateral hyperdensity crossing the midline.[3]](/index.php/File:Ct_image_primary_central_nervous_system_lymphoma_image_1.jpg)
Chest, Abdomen, and Pelvic CT
- Chest, abdomen, and pelvic CT scans may be used to exclude any occult systemic disease from the spread of primary central nervous system lymphoma.[2]
References
- ↑ 1.0 1.1 1.2 1.3 Radiographic features of primary CNS lymphoma. Dr Amir Rezaee and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/primary-cns-lymphoma. Accessed on February 18, 2016
- ↑ 2.0 2.1 Diagnostics of primary CNS lymphoma. National cancer institute 2016. http://www.cancer.gov/types/lymphoma/hp/primary-cns-lymphoma-treatment-pdq. Accessed on February 19, 2016
- ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC