CNS lymphoma

Case contributed by Frank Gaillard
Diagnosis almost certain

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

ct
Axial
non-contrast
Axial C+ portal
venous phase
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A high-attenuation mass with with a small area of central low density and surrounding minor edema demonstrates intense enhancement on post-contrast.

There is the suggestion of leptomeningeal enhancement elsewhere, most notably in the right parietal region; however, this is difficult to confirm on a single image.

mri
Axial
DWI
Axial
ADC
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The lesion seen on CT demonstrates marked diffusion restriction (high DWI signal, and low ADC values, much lower than adjacent brain).

Case Discussion

This patient had known systemic lymphoma, and thus, this represents secondary CNS lymphoma. 

The typical appearance in patients with normal immunity is a solitary enhancing mass. This is typically of high density on non-contrast CT and demonstrates restriction on DWI.

Image courtesy of R. Larsen and A. Coulthard. Royal Brisbane and Women’s Hospital, Brisbane, Australia.

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