CNS lymphoma

Case contributed by A.Prof Frank Gaillard

Patient Data

Age: 60
Gender: Male
MRI

Multiple periventricular regions of vivid contrast enhancement, which are low on T2 and surrounded by relatively little oedema. They also demonstrate restricted diffusion in keeping with a highly cellular tumour. Features are characteristic of CNS lymphoma. 

Pathology

Histology

MICROSCOPIC DESCRIPTION:

The sections show a densely cellular malignant tumour in the white matter. It forms diffuse sheets and cuffs around the blood vessels. The tumour cells are intermediate in size. They have enlarged clefted and hyperchromatic nuclei, prominent nucleoli and scanty cytoplasm. The tumour cells are CD20, PAX-5, bcl-2, bcl-6 and MUM1 positive. The Ki-67 index is about 80%. They are CD3 and CD10 negative. There is insufficient tissue for EBER-CISH. The features are those of diffuse large B-cell lymphoma with activated B-cell-like phenotype.

DIAGNOSIS:

Diffuse large B-cell lymphoma.

Case Discussion

This is a typical radiological appearance of CNS lymphoma, and the diagnosis can be suggested with a high degree of certainty. 

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Case information

rID: 30084
Case created: 17th Jul 2014
Last edited: 31st Dec 2016
Inclusion in quiz mode: Included

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