Search

Eleven spleens removed surgically from patients with malignant lymphoma were compared according to gross, histologic, and cytologic appearances with spleens surgically removed from patients with nonmalignant disorders. The gross comparison indicates that the lymphomatous spleens were 10 to 20 times heavier than the nonmalignant spleens. The cut sectional surfaces revealed three types: (1) diffuse-homogeneous, (2) multinodular, (3) solitary and multinodular. Histologically they presented with a diffuse or nodular pattern. Splenic trabeculae and subendothelial spaces were markedly infiltrated by malignant cells. Sinusoidal congestion was prominent. Cytologically, five cases of splenic lymphomas were classified as well-differentiated lymphocytic lymphoma, five cases as poorly-differentiated lymphoma, and one case as composite lymphoma. Although numerous homogeneous lymphoid nodules were noted in the nodular lymphomas, no primary or secondary follicles or perifollicular marginal zones were seen in any of the cases of splenic lymphoma. In one spleen there were two cytologically distinct malignant lymphomas (composite lymphoma) consisting of a focal histiocytic lymphoma and a well-differentiated lymphocytic lymphoma. To our knowledge, this unusual association in the spleen has not been reported before. This experience suggests that the gross and microscopic alterations in primary splenic lymphoma can be differentiated from those seen in benign splenic disorders.

Objective To describe the magnetic resonance imaging (MRI) appearance of central nervous system lymphoma. Methods We retrospectively reviewed MRI images of 40 patients who had pathologically proven primary central nervous system lymphoma (PCNSL) and received treatment in Binzhou People's Hospital, Shandong, China from January to December in 2014. Location, size and form of tumor was observed and relevant data were recorded for analysis. Results Foci of 40 cases of PCNSL all located in brain, among which. 18 cases were single (45.0%) and 22 cases were multiple (55.5%). Of 96 Foci, 84 were supratentorial, 12 were subtentorial. Enhanced MRI scanning showed that, most Foci had significant homogenous enhancement, shaping as multiple nodular or lumpy, and few had ring-enhancement. MRI suggested that, T1 signal of most Foci concentrated on low signal segment and T2 signal gathered on high signal segment, suggesting a significant homogeneous enhancement; moreover, mild and medium edema surrounded the tumor. They were pathologically confirmed as B cell derived non-hodgkin lymphoma. Except one case of Burkitt lymphoma, the others were all diffuse large B cell lymphoma which was observed with diffuse distribution of cancer cells (little cytoplasm, large nucleus, rough perichromatin granule) in same size. Fifteen cases were observed with sleeve-like infiltration of cancer cells around blood vessels. No case was found with hemorrhage, necrosis or calcification. Conclusion Pathological foundation of PCNSL determines its characteristic MRI performance. Typical case of PCNSL can be diagnosed accurately by MRI.