Parenchymal lymphoma of the brain on initial MR imaging: A comparative study between primary and secondary brain lymphoma

Background and purpose

Parenchymal lymphomatous brain masses have not been investigated considering if they are primary or as a part of systemic lymphoma (secondary) on imaging studies previously. We aimed to determine characteristics of the secondary parenchymal lymphomatous involvement of the brain and to find if there is any radiologic feature to help discrimination of untreated primary and secondary central nervous system lymphoma on patients’ initial magnetic resonance imaging.

Materials and methods

We evaluated MR images of 18 patients with the diagnosis of primary (n = 12) and secondary central nervous system lymphoma (n = 6). We considered the number, localization, enhancement pattern, signal characteristics, diffusion properties, presence of hemorrhage and presence of butterfly pattern on MR imaging at initial presentation.

Results

Secondary central nervous system lymphomas predominantly presented as multiple (n = 4, 66.7%) lesions. Homogenous nodular enhancement and supratentorial white matter involvement were present in all patients with butterfly pattern and infiltrative/perivenular enhancement in half (n = 3) of the patients. Deep gray matter (n = 1, 16.7%) and infratentorial involvement (n = 1, 16.7%) were scarce and no ring enhancement was observed. There was no statistically significant difference in any of the investigated MR features between the two groups.

Conclusion

Statistical analyses revealed no significant distinctive radiologic characteristics between primary and secondary lymphoma of the brain parenchyma.