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IVL is characterized by a propensity for intravascular tumor cell proliferation. Premortem diagnosis of IVL is difficult because of its nonspecific clinical, laboratory, and imaging manifestations. This study examined cerebral MR imaging patterns of IVL and their changes with and without chemotherapy. Nine of 11 patients studied presented with abnormal findings. We define 5 patterns of abnormal MR imaging findings: 1) infarctlike lesions, 2) nonspecific white matter lesions, 3) meningeal enhancement, 4) masslike lesions, and 5) hyperintense lesions in the pons of T2WI. Seven patients presented with only 1 pattern, while 2 patients presented with multiple patterns. Lesions in 7 treated patients responded to chemotherapy. Pathologic specimens revealed intravascular tumor cell infiltration with associated infarctions, necrosis, congestion, demyelination, vasculitis, and tumor cell extravasation. We conclude that MR imaging patterns can be possible manifestations of intravascular-dominant infiltration by tumor cells with associated occlusion or inflammation, depending on the level of affected vessels. |
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brain biopsy cerebral infarction cerebral infarction,hemorrhagic cerebrovascular accident,mimics chemotherapy,CNS treatment and complications with demyelinating disease intraluminal tumor lymphoma lymphoma involving CNS lymphoma,primary of CNS meningeal enhancement meningitis MRI MRI,abnormal MRI,contrast enhanced MRI,mass effect on MRI,ring sign neoplastic angioendotheliosis neuropathology pons,lesion of treatment of neurologic disorder white matter disease
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