Comparison of radiologic and clinical characteristics between low-grade and high-grade PCNSL in immunocompetent patients
| Low-Grade PCNSL | High-Grade PCNSL |
|---|---|
| Radiological morphology | |
| Moderate and inhomogeneous or absent contrast enhancement frequent | Usually strong and homogemeous contrast enhancement |
| Localization of lesions often without contact to subarachnoid space | Lesions typically in contact with the subarachnoid space |
| Hyperintensity of T2-weighted images often present | Hyperintensity on T2-weighted images possible |
| Location in deep brain structures and spine common | Location in deep brain structures and spine possible but infrequent |
| Clinical characteristics | |
| Indolent clinical course possible | Aggressive clinical course almost invariably seen |
| Delays in diagnosis establishment possible due to paucity of symptoms and variable radiologic appearance | Diagnosis establishment usually rapid due to severe symptoms and typical radiological appearance |
| Long survival with absence of complete tumor remission possible | Survival without complete remission usually short |
| Long survival after local treatment (surgery, local radiotherapy) possible | Survival with local treatment short, whole brain treatment required |
Note.—PCNSL indicates primary central nervous system lymphoma.