Patients with typical tumefactive demyelinating lesions (TDLs) have younger age of onset than those with sentinel lesions of primary central nervous system lymphoma (PCNSL), and hypodense lesions are seen on computed tomography (CT) of the brain in about 95 percent of patients with TDLs, according to a study published online Aug. 18 in Frontiers in Immunology.
Chenjing Sun, from The First Medical Center of PLA General Hospital in Beijing, colleagues conducted a retrospective study involving 116 patients with TDLs and 150 patients with PCNSLs to analyze clinical features, neuroimaging findings, and pathological characteristics.
The researchers found that the age of onset was 37 ± 14 years in TDLs and 58 ± 13 years in PCNSLs. Headache was the main onset symptom in TDLs, while in PCNSLs, cognitive impairment was noted frequently. In most cases of TDL (94.8 percent), CT brain scan images showed hypodense lesions, while about 80 percent of patients with PCNSL had hypodense lesions. In TDLs, the presence of Creutzfeldt-Peters cells may serve as an important feature.
“Distinguishing sentinel lesions of PCNSL and TDLs during an early disease stage remains a challenge,” the authors write.