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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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