Findings: A confluent space-occupying lesion involving the right occipital lobe, white matter along the temporal horn of the right lateral ventricle, splenium of the corpus callosum, and the adjacent dentate gyrus, as well as para-hippocampal gyrus, is noted. A smaller focal lesion is seen in the left occipital lobe. The larger right cerebral lesion is isointense on T1 and mildly hyperintense on T2 weighted images. This lesion has central necrosis, minimal internal bleed, mild diffusion restriction, surrounding vasogenic edema, and shows moderate heterogeneous enhancement. Mild mass effect is seen over the occipital horn and atrium of the right lateral ventricle; minimal contralateral midline shift is also seen.
Impression: Enhancing supratentorial brain lesions; possible differential diagnosis includes lymphoma and multicentric glioblastoma.