MRI
What is expected histologically in patients with intravascular lymphoma with CNS involvement?
Small round blue cells filling the brain arterioles with minimal if any perivascular spread.
What are some general differential considerations on imaging?
Vasculitis, demyelinating disease, neurosarcoidosis, and lymphomatosis cerebri.
What other organ system is commonly involved?
Skin, presenting with elevated plaques and nodules.
MRI brain demonstrates extensive patchy hyperintensity on T2/FLAIR throughout the deep white matter. There is corresponding restricted diffusion involving the majority of the lesions with a peripheral halo of T2 shine through on ADC map. The majority of the lesions are associated with punctate and nodular susceptibility, suggestive of microhemorrhage. On post contrast T1, the lesions display stippled enhancement.