CNS lymphoma

Case contributed by Dr Naim Qaqish

Presentation

Headache and focal deficit involving the left side upon examination.

Patient Data

Age: 60 years
Gender: Female
MRI

Round signal abnormality located in the right basal ganglia extending down into the right side of the midbrain reaching the right anterolateral aspect of the pons, with perifocal vasogenic edema.  Mass effect with compression of the ventricular system and moderate midline shift to the left. The mass shows restricted diffusion, with strong mainly peripheral enhancement with blurred margins.

Faint inhomogeneous enhancement is also seen in the left corona radiata and left side of the midbrain.

Ill-defined signal abnormalities in both cerebral hemispheres, pons, medulla oblongata, superior and middle cerebellar peduncles more in the right side and cerebellar white matter, more in the right side, partly due to chronic ischemia.

Round enhancing lesion at the left side of the midbrain arising from the adjacent left side of the tentorium probably due to a meningioma.

Case Discussion

This lady presented to the ER with headache and left-sided weakness.  When referred to the radiology department she was thought of having a stroke. Upon evaluation of the patient by MRI scan, images demonstrated typical appearances of lymphoma.

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Case information

rID: 73088
Published: 23rd Dec 2019
Last edited: 28th Dec 2019
Inclusion in quiz mode: Included

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