Multiple CNS lymphoma

Case contributed by Keshaw Kumar
Diagnosis almost certain

Presentation

Altered sensorium.

Patient Data

Age: 65 years
Gender: Male

NCCT Brain

ct
This study is a stack
Axial
non-contrast
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

Multiple well-defined homogenously hyperdense lesions involving the right frontal lobe, left inferior frontal lobe, and splenium of the corpus callosum with marked surrounding edema.

mri
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Sagittal
T2
This study is a stack
Coronal
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
SWI
This study is a stack
Axial
T1 C+
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Info

Multiple well-defined rounded mass lesions involving the right frontal lobe, left inferior frontal lobe, and splenium of the corpus callosum with marked surrounding edema. These lesions appear iso to hypointense on T1 weighted images, and hypointense on T2/FLAIR. High signal on DWI and very low ADC values, consistent with pronounced diffusion restriction. Microhemorrhage are seen on SWI. Vivid homogeneous enhancement on T1 post-contrast images.

Case Discussion

Overall imaging findings are highly suggestive of multiple CNS lymphoma. Unfortunately the patient passed away prior to biopsy.

Co-author: Dr. Avijit Kashyap (Consultant Neurosurgeon).

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