Parenchymal central nervous system involvement in aggressive B-cell lymphoma: retrospective analysis of clinical and MRI features in a Chinese population

Abstract

Introduction Secondary central nervous system lymphoma (SCNSL) was defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. Parenchymal involvement of the CNS in aggressive B-cell lymphoma was rare and remains a diagnostic dilemma. Materials and Methods In our study, we retrospectively analyzed the clinical and magnetic resonance imaging (MRI) features of 26 parenchymal SCNSL patients. In addition, we compared MRI features between SCNSL and primary CNS lymphoma (PCNSL) patients after 1:1 propensity score matching. Results Among SCNSL patients, the median CNS relapse time was 3 months, and multiple lesions were found in 76.9% of the cases. In PCNSL, this percentage was 34.8% (p=0.023). None of the SCNSL patients and 11.5% of the PCNSL patients had solitary infratentorial lesions (p=0.011). Conclusions the majority of parenchymal involvement occurred within the first year of systemic lymphoma, in which mostly cases presenting with multiple and supratentorial locations, unlike what was found in PCNSL.

Central nervous system involvement in adult-onset hemophagocytic lymphohistiocytosis secondary to lymphoma: a case presentation and literature analysis

“…Secondary CNS lymphoma mostly involves deep gray or white matter, and lesions show enhancement on enhanced T1-weighted image and diffusion restriction (27,28). The patient described in this report had no limited spaceoccupying lesions and no enhancement, which is inconsistent with lymphoma.…”