Diffusion tensor images and magnetic resonance spectroscopy in primary central nervous system T-cell lymphoma: A case report

Purpose: Primary central nervous system lymphoma (PCNSL) is rare and usually B cell in origin. T-cell lymphoma constitutes only 1.8% to 4.6% of the PCNSL, and may present as solitary or multiple homogeneous enhanced lesions. There have been few reports showing unusual leukoencephalopathy in PCNSL, which may be confused with other white matter diseases including multiple sclerosis and acute disseminated encephalomyelitis. Case Report: We reported a patient with T-cell PCNSL who presented a progressive dull response and extra-pyramidal symptoms. Brain magnetic resonance imaging showed multiple focal leukoencephalopathy. Diffusion weighted imaging demonstrated hyper-intensity lesions and apparent diffusion coefficient images showed hypo-intensity lesions. Diffuse tensor images showed decreased fractional anisotropy. Pathology examination finally confirmed T-cell lymphoma. Conclusion: Although recent development of neuro-imaging studies, the diagnosis of PCNSL still await further pathological confinnation in some occasions.