Primary central nervous system lymphoma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

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:

• 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:

• 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.
• It should be noted that in patients who are immunocompromised (typically HIV/AIDS or post-transplant), enhancement is more heterogeneous.

Gallery

• 
  _{Single image from a non-contrast CT scan demonstrating a vague bilateral hyperdensity crossing the midline.}

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