MRI in diagnosis of primary intracerebral malignant lymphoma

Objective: To investigate MRI features of primary intracerebral malignant lymphoma (PICML). Methods: MRI findings in 10 patients with pathologically-proved PICML were retrospectively analyzed. Results: 35 lesions were identified in 10 patients, single lesion was seen in 2 and multiple lesions in 8, 13 lesions located in the deep white matter, 2 in the callus corpus, 10 in the cerebellum, 1 in the brain stem and 6 in the surface. The lesions presented as node or mass in shape with slight preitumorous edema and mass effect. On plain MRI scans, all lesions presented as iso-or slight hypointense on T\-1WI, while all lesions presented as iso-or slight hyperintense on T\-2WI and slight hyperintense or hyperintense on FLAIR, most of the lesions presented as slight hyperintense or hyperintense on DWI. Obvious homogenous mass-like or nodular enhancement were seen on Gd-DTPA –enhanced MRI, 4 presented as “incision sign” and “angular sign”. Conclusion: Primary intracerebral malignant lymphoma has features on MRI images, correct diagnosis can be made in most cases when imaging findings are combined with clinical information.