Primary CNS lymphoma
Discussion:
The other differentials for this particular appearance in an immunocompromised individual may include:
-
toxoplasmosis:
- presence of subependymal spread suggests PCNSL
- significant choline peak elevation not generally observed in toxoplasmosis
- markedly elevated lipid/lactate peak seen in toxoplasmosis
- on perfusion weighted imaging (PWI) there is markedly increased rCBV seen in PCNSL which is relatively diminished in toxoplasmosis
- hemorrhage can be seen in toxoplasmosis but rarely in PCNSL
- glioblastoma multiforme:
- parenchymal and extra-axial sarcoidosis
- metastasis
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