Lymphomatoid granulomatosis (CNS manifestations)
Lymphomatoid granulomatosis of the central nervous system is uncommon, but represents the second most common site of involvement in patients with systemic lymphomatoid granulomatosis, after the lungs, which are most commonly involved.
For a general discussion of the underlying condition, including epidemiology and pathology, please refer to the article lymphomatoid granulomatosis.
Neurologic symptoms are fairly common, seen in around 30% of cases, usually in the setting on systemic or cutaneous symptoms 1.
MRI is the modality of choice for assessing patients with suspected lymphomatoid granulomatosis.
Appearances are very variable with lesions seen in all compartments (supra- and infratentorial) and demonstrating a wide range of morphology.
Generally, lesions were located in the periventricular white matter but can extend to involve cortex.
Punctate or linear T2 hyperintensities within perivascular spaces are also characteristic and show contrast enhancement 1,2. Larger lesions may be solid or demonstrate ring enhancement. They have variable surrounding oedema and may be associated with leptomeningeal enhancement 1.
- overview of lymphoma
WHO classification of tumours of haematopoietic and lymphoid tissues
- Hodgkin lymphoma
mature B-cell lymphoma
- Burkitt lymphoma
- follicular lymphoma
- lymphoplasmacytic lymphoma (Waldenström's macroglobulinaemia)
- lymphomatoid granulomatosis
- mantle cell lymphoma
- mature T-cell and NK-cell lymphoma
- post-transplant lymphoproliferative/lymphoproliferation disorders
- mature B-cell lymphoma
- location-specific lymphomas
- central nervous system
- head and neck lymphoma
- thoracic lymphoma
- gastrointestinal lymphoma
- hepatobiliary lymphoma
- genitourinary lymphoma
- musculoskeletal lymphoma
- cutaneous lymphoma
- lymphoma staging
- 1. Tateishi U, Terae S, Ogata A et-al. MR imaging of the brain in lymphomatoid granulomatosis. AJNR Am J Neuroradiol. 2001;22 (7): 1283-90. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 2. Degnan AJ, Levy LM. Neuroimaging of rapidly progressive dementias, part 2: prion, inflammatory, neoplastic, and other etiologies. AJNR Am J Neuroradiol. 2014;35 (3): 424-31. doi:10.3174/ajnr.A3455 - Pubmed citation