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Fig. 1C —56-year-old woman presenting with a typical region of MALT
lymphoma on MRI. Sagittal T2-weighted fast spin-echo fat-suppressed MR image
of right breast; (TR/TE 4,000/98, slice thickness 3 mm, slice spacing 3 mm;
field of view 20 cm, acquisition matrix 256 x 192) shows ovoid 1.6
x 0.7 cm lesion (arrow) in upper breast, with slightly higher
signal intensity than adjacent glandular tissue (A). Contrast-enhanced
water-specific 3D gradient-echo image (centric 3D spectral-spatial excitation
spoiled gradient echo with magnetization transfer [3DSSMT] after 0.1 mmol/kg
IV of gadopentetate dimeglumine, TR/TE 31.3/8.73, slice thickness 1.5 mm,
field of view 20 cm, matrix 512 x 192) revealed multiple foci of
contrast enhancement, largest being 1.6 x 0.7 cm in upper outer quadrant
(arrow) (B) that had increased in size and number since
previous study 5 months earlier (not shown). Time signal-intensity curves from
dynamic 3D spiral MRI (scans repeated every 10.6 sec; see reference
[6] for scan parameter details)
performed during initial contrast enhancement ("wash-in" phase)
and after high-resolution 3DSSMT ("wash-out" phase) revealed rapid
initial enhancement during wash-in phase followed by gradual enhancement
during wash-out phase (C). MRI localized biopsy of upper breast lesion
revealed dense lymphoid infiltrate composed of monomorphous small lymphocytes
involving breast parenchyma and surrounding benign breast ducts (D) (H
and E stain x100). Histologic findings were same as MRI-guided biopsy of
initial left breast lesion (not shown).
