MRI features of lymphoma in spinal area

Abstract

Objective To analyze MR imaging manifestations of spinal area lymphoma in order to improve the recognition and understanding of the disease. Methods A group of 45 patients with pathologically or clinically proven spinal area lymphoma were reviewed. Five cases were primary NHL,40 cases were secondary with 9 HL and 31 NHL (27 B-cell type NHL and 4 T-cell type NHL). MR Imaging findings were analyzed and correlated with clinical and pathologic findings. Results (1) Location of lesions: 13 cases were focal type and 32 cases were multifocal type. All of the 5 patients with primary lymphoma were focal type, while 32 of 40 cases of secondary lymphoma were multifocal type. (2) Type oflesions: ①Vertebral destruction: 27 cases manifested as bone destruction with 23 of them had soft tissuemass and the extent of soft tissue masses were larger than that of bone destruction in 18 cases.②Soft tissuemasses: 6 cases manifested as soft masses without obvious bone destruction, of which 5 cases had soft tissuemasses imbedded vertebrae and communicated paravertebral and epidural spaces through intervertebralforamen.③Bone marrow infiltration: 9 cases of secondary spinal lympboma had signal intensity changes ofbone marrow without obvious cortical bone destruction and soft tissue mass. ④ Spinal cord infiltration:3 cases of secondary spinal lymphoma had spinal cord swelling and signal intensity changes. (3) MRIfindings: all lesions of bone destruction and marrow infiltration manifested as hypointense on T1-weightedimages, hypointense, isointense or hyperintense on T2-weighted images and hyperintense on T2-weightedimages with fat-suppression technique. All soft tissue masses were homogeneous hypointense on T1-weightedimages and hyperintense on T2-weighted images. After intravenous injection of contrast media, the lesions ofthe bone and the soft tissue showed mild or moderate enhancement without remarkable cystic degenerationand necrosis. Conclusions Most of the spinal area lymphoma is the secondary B type NHL with complexMRI manifestation. Osteolytic lesion with contiguous paravertebral soft tissue mass imbedded vertebrae whichcommunicated paravertebral and epidural spaces through intervertebral foramen with a mild or moderateenhancement may suggest the diagnosis of this rare disease. Key words: Lymphoma; Bone neoplasms; Spinae; Magnetic resonance imaging