PMC4306264_01
Primary central nervous system lymphoma. Plain MR images show a right fronto-parietal tumor: hypointense on the T1-weighted image, with small foci of hyperintense bleeding (A), with low signal within the tumor core and diffuse hyperintense surrounding edema on the T2-weighted image (B) and strong homogenous contrast enhancement on the T1-weighted post-contrast image (C).
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T1-weighted images with hyperintense areas of subacute bleeding (Figure 1A). T2-weighted and FLAIR images revealed low signal with significant hyperintense vasogenic edema in the surrounding white matter (Figure 1B). The tumor showed strong homogenous contrast enhancement (Figure 1C).
Primary central nervous system lymphoma showing diffusion restriction on the DWI image (A) and the ADC map (B).
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In DWI the lesion showed restricted diffusion (high signal on DWI images and low signal on ADC maps) with ADC values of 0.67x10-3 for the whole tumor and minimal ADC value of 0.51x10-3 (with normal ADC values of approx. 0.7-0.75x10-3) (Figure 2).
Primary central nervous system lymphoma showing hypoperfusion within the tumor core (outlined in violet, white arrow) on the CBV map overlaid on the contrast-enhanced T1-weighted image (A) and characteristic shape of the signal intensity curve (B) returning above the baseline level.
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PWI study revealed low values of CBV relative to the contralateral white matter with mean rCBV values of 0.43 for the whole tumor core and 0.79 of maximal rCBV (Figure 3A). The signal intensity curve from the tumor core showed a characteristic shape with the return above the baseline level (Figure 3B).