MRI features of intra-axial histiocytic brain mass lesions. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Luna, L.P.; Drier, A.; Aygun, N.; Mokhtari, K.; Hoang-Xuan, K.; Galanaud, D.; Donadieu, J.; Dormont, D.; Haroche, J.; Martin-Duverneuil, N.
• Is Part Of: Clinical radiology. Volume 76:Issue 2(2021)
• Page Start: 159.e19
• Page End: 159.e28
• Publication Date: 2021-02
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2020.09.015
• Languages: English
• ISSNs: 0009-9260

Abstract

Abstract : AIM: To describe MRI features, including diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and perfusion-weighted imaging (PWI), of intra-axial tumour-like presentations of four different subtypes of histiocytosis. MATERIAL AND METHODS: The brain MRI findings of 23 patients with histologically proven histiocytosis were reviewed retrospectively (11 Langerhans cell histiocytosis [LCH], eight Erdheim–Chester disease [ECD], one overlap form LCH/ECD, two Rosai–Dorfman disease [RDD], and one haemophagocytic lymphohistiocytosis [HLH]) with single or multiple enhancing intraparenchymal brain lesions. RESULTS: Histiocytic brain mass lesions show some similar MRI features including Supra and/or infratentorial and/or paraventricular subcortical well-delineated masses, linear ependymal enhancement along the ventricles and brain stem lesions. Masses always present with mixed hyper- and hypointense signal on T2-weighted imaging (WI). Their enhancement is often homogeneous. Apparent diffusion coefficient (ADC) values are often normal or elevated. CONCLUSION: The presence of multiple periventricular and subcortical enhancing lesions with mixed signal intensity on T2WI and normal or high ADC values should lead radiologists to consider the diagnosis of histiocytic lesions and search for associated systemic lesions. Highlights: Different types of histiocytoses differ clinically and immunohistologically. Cerebral histiocytic masses share similar features with many other brain pathologies. Histiocytic intra-axial mass lesions share some similar MRI features. Lesions often show subcortical, periventricular and pons/brainstem involvement. Frequent T2WI hypointensities, high ADC values and homogeneous contrast enhancement.