Santral Sinir Sistemi Lenfomaları: Görüntüleme Bulguları ve Ayırıcı Tanı
Özet
Santral sinir sistemi (SSS) lenfomaları nadir ancak klinik açıdan önemli tümörlerdir ve değişken görüntüleme bulguları nedeniyle tanısal güçlük oluşturur. Bu bölümde; primer diffüz büyük B hücreli lenfoma, immün yetmezlik ile ilişkili varyantlar, sekonder SSS tutulumu vedural ile intravasküler lenfoma gibi daha nadir alt tipler kapsamlı biçimde ele alınmaktadır. Bilgisayarlı tomografi, konvansiyonel MRG, ileri MRG teknikleri (difüzyon, perfüzyon, spektroskopi) ve metabolik görüntüleme (PET/SPECT) bulgularına odaklanılmıştır. T2 hipointensitesi, difüzyon kısıtlılığı, homojen veya halka tarzı kontrastlanma ve karakteristik perfüzyon/spektroskopi profilleri gibi temel radyolojik özellikler patoloji ve klinik bulgularla birlikte tartışılmaktadır. İmmünkompetan ve immünkompromize hastalardaki farklılıklar, glioblastom ve metastaz gibi ayırıcı tanılar ve biyopsi ile tedavi planlamasında görüntülemenin rolü vurgulanmıştır. Ayrıca Dünya Sağlık Örgütü’nün güncel sınıflandırmaları ve yeni gelişmeler özetlenmiştir. Bu derleme, radyolog ve klinisyenlere SSS lenfomalarının erken tanınması, doğru ayırıcı tanı ve tedavi yönetiminde pratik bilgiler sunmayı amaçlamaktadır.
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