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% of patients with TDLs, according to a study published in Frontiers in
Immunology. Researchers conducted a retrospective study of 116 patients with TDLs and 150 patients with PCNSLs to analyze clinical features, neuroimaging findings, and pathological characteristics. The age of onset was 37±14 in TDLs versus 8±13 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%), CT brain scan images showed hypodense lesions, while about 80% 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 study authors wrote.