Miyasaka K, Terae S
Department of Radiology, Hokkaido University School of Medicine.
Rinsho Shinkeigaku. 1995 Dec;35(12):1467-9.
We reviewed the neuroimaging studies of five patients with intravascular malignant lymphomatosis (IML). All five patients had cerebral symptoms and three had spinal cord or root symptoms. Initial brain CTs, in two patients at the onset of cerebral symptoms, were normal. Brain MR imaging, conducted in four patients during the course of IML, showed multiple white matter lesions which were hyperintense on T2-weighted images. Some of the lesions involved cerebral cortices, and some had mass effect. Serial MR imaging was performed in three patients, and the lesions decreased in size during steroid or CHOP therapy. Gd-DTPA-enhanced study which was conducted in one patient demonstrated enhancement of the white matter lesions. Review of the literature revealed various CT or MR findings; single or multiple cortical or subcortical lesions with or without mass effect, periventricular lesions, and spinal cord lesions. Lesions may or may not be enhanced. Because neuroimaging findings are non-specific, correct diagnosis is difficult to make by imaging studies alone. One should always consider the possibility of IML in the interpretation of radiological images.
我们回顾了5例血管内恶性淋巴瘤病(IML)患者的神经影像学研究。所有5例患者均有脑部症状,3例有脊髓或神经根症状。2例患者在出现脑部症状时的初始脑部CT检查结果正常。4例患者在IML病程中进行了脑部磁共振成像(MR成像),显示多个白质病变,在T2加权图像上呈高信号。部分病变累及大脑皮层,一些有占位效应。3例患者进行了系列MR成像,病变在类固醇或CHOP治疗期间体积缩小。1例患者进行的钆-二乙三胺五乙酸(Gd-DTPA)增强研究显示白质病变有强化。文献回顾显示有各种CT或MR表现;有或无占位效应的单个或多个皮层或皮层下病变、脑室周围病变及脊髓病变。病变可能有强化或无强化。由于神经影像学表现不具特异性,仅通过影像学检查难以做出正确诊断。在解读放射影像时应始终考虑IML的可能性。