NIMG-93. CORRELATING RELATIVE LEVEL OF IMMUNOCOMPETENCE FOR CNS LYMPHOMA BY RADIOLOGIC CHARACTERISTICS: A CASE SERIES

Abstract

Abstract Radiologically, central nervous system lymphoma (CNSL) presents differently in immunocompetent versus immunosuppressed states. Most patients with immunocompetent CNS lymphoma present with a solitary, deep, homogeneously enhancing lesion while patients with immunocompromised CNS lymphoma frequently have multifocal, centrally necrotic enhancing brain lesions. To date, there have been no radiologic features described along a spectrum of relative levels of immunocompetence. A single institution review on twelve patients with primary and secondary CNSL included clinical factors at diagnosis that are associated with varying levels of relative immunocompromised state. We collected qualitative data on age, prior cancer, radiation, chemotherapy, HIV, diabetes mellitus, steroid/immunosuppressant use, and quantifiable data including white blood cell, neutrophil, and lymphocyte counts. These factors were stratified for severity and correlated with findings on imaging. Our study identified patients with a minor level of immunocompromised state were more likely to develop multifocal disease, while patients with more severe immunocompromised states were likely to develop necrosis. Although our study is limited as a retrospective analysis, these findings suggest that the radiographic findings can present as a spectrum which can reflect a relative level of immunocompetence. This study warrants further evaluation in a larger and prospective cohort for validation.