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Extensive leptomeningeal enhancement is noted. The pineal gland is bulky and enhances too vividly.
A lumbar puncture was performed.
Smears contain numerous large abnormal cells, showing cleaved nuclear and irregular nuclear contours, with scattered small lymphocytes consistent with recurrent large cell lymphoma. DCBCL CNS.
This patient had systemic large cell lymphoma, and now developed a CNS relapse.