HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2371041087v1 237/1/265    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Patsalides, A. D. Articles by Wilson, W. H. Search for Related Content PubMed PubMed Citation Articles by Patsalides, A. D. Articles by Wilson, W. H.

Lymphomatoid Granulomatosis: Abnormalities of the Brain at MR Imaging¹

¹ From the Department of Diagnostic Radiology, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bldg 10, Room 1C660, 9000 Rockville Pike, Bethesda, MD 20892-1182 (A.D.P., G.A., A.D., N.J.P.); Georgetown University Hospital, Washington, DC (A.D.P.); and Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Md (U.H., J.J., N.G., E.S.J., W.H.W.). From the 2001 RSNA Annual Meeting. Received June 21, 2004; revision requested August 27; revision received November 21; accepted December 30. Address correspondence to A.D.P. (e-mail: apatsalides{at}cc.nih.gov).

PURPOSE: To retrospectively evaluate the magnetic resonance (MR) imaging features of lymphomatoid granulomatosis in the brain.

MATERIALS AND METHODS: The study, including retrospective analysis of data, was approved by the institutional review board of the National Cancer Institute and complied with Health Insurance Portability and Accountability Act. All patients gave written informed consent. Thirty-one patients with pathologically confirmed lymphomatoid granulomatosis were enrolled in a natural history and treatment study at the National Institutes of Health. Twenty-five patients (median age, 50 years; range, 18–62 years; 18 men, seven women) were evaluated with MR imaging of the brain at study entry for the presence of brain lesions and enhancing characteristics. Patients with abnormal findings were reexamined at intervals ranging from 2 to 19 months, as medically indicated. Cytologic analysis and flow cytometry of cerebrospinal fluid (CSF) were performed. Statistical analysis was performed to compare neurologic and CSF findings in patients with brain MR imaging abnormalities and in patients without abnormalities. The sensitivity of brain MR imaging was compared with that of CSF studies.

RESULTS: Thirteen (52%) of 25 patients evaluated with MR imaging had a variety of brain abnormalities. Multiple focal intraparenchymal lesions, which exhibited T2 prolongation and commonly punctate or linear enhancement, were the most frequent abnormalities, and they were encountered in seven patients. The second most common finding was involvement of leptomeninges and cranial nerves, which manifested as abnormal enhancement on MR images obtained after contrast agent administration. This abnormality was seen in six patients. Involvement of dura mater was noted in another. Four patients had brain masses. Two had abnormal engorgement and intense enhancement of the choroid plexus. Most lesions resolved after treatment, but seven resulted in lacunar infarctions. Abnormal B cells were detected in the CSF with either cytologic techniques or flow cytometry in five patients.

CONCLUSION: Lymphomatoid granulomatosis has a high rate of central nervous system involvement and a variable spectrum of lesions at MR imaging. Findings in this study suggest that MR imaging is more sensitive than CSF cytologic analysis or flow cytometry for detection of central nervous system involvement from lymphomatoid granulomatosis.

© RSNA, 2005

This article has been cited by other articles:

				H. Ishiura, M. Morikawa, M. Hamada, T. Watanabe, S. Kako, S. Chiba, T. Motokura, A. Hangaishi, J. Shibahara, M. Akahane, et al. Lymphomatoid Granulomatosis Involving Central Nervous System Successfully Treated With Rituximab Alone Arch Neurol, May 1, 2008; 65(5): 662 - 665. [Abstract] [Full Text] [PDF]

				A.T.K. Kendi, A.M. McKinney, H.B. Clark, and S.A. Kieffer A Pediatric Case of Low-Grade Lymphomatoid Granulomatosis Presenting with a Cerebellar Mass AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1803 - 1805. [Abstract] [Full Text] [PDF]

				J. O. Fleming, B. M. Keegan, and J. E. Parisi A 52-year-old man with progressive left-sided weakness and white matter disease Neurology, August 7, 2007; 69(6): 600 - 606. [Full Text] [PDF]