Presentation
Patient presents with progressive encephalopathy, papilledema, and anemia.
Patient Data
Unenhanced CT of the brain demonstrates patchy hypoattenuation throughout the deep white matter. The lesion in the anteroinferior left frontal white matter displays subtle central isodensity.
MRI brain demonstrates extensive patchy hyperintensity on T2/FLAIR throughout the deep white matter. There is corresponding restricted diffusion involving the majority of the lesions with a peripheral halo of T2 shine through on ADC map. The majority of the lesions are associated with punctate and nodular susceptibility, suggestive of microhemorrhage. On post contrast T1, the lesions display stippled enhancement.
Case Discussion
This case shows the typical (though fairly non-specific) imaging appearance of intravascular lymphoma with linear/stippled enhancement and microhemorrhage in the deep white matter. The case was confirmed post mortem on autopsy.
Co-Author: Samantha Scott
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