Primary CNS lymphoma

Case contributed by Fabio Macori
Diagnosis certain

Presentation

Headache and increasing confusion. No sided weakness.

Patient Data

Age: 45 years
Gender: Male
mri
This study is a stack
Axial
FLAIR
This study is a stack
Axial
PD
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
T1
This study is a stack
Coronal
T1
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Coronal
T2
This study is a stack
Sagittal
T1
This study is a stack
Axial
T1 C+
This study is a stack
Sagittal
T1 C+
This study is a stack
Coronal
T1 C+
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Info

A large, round-shape, mass involving the territory from hypophysis to ventricles. After contrast a homogeneous impregnation is evident. Edema is present surrounding the lesion.

Case Discussion

Lymphoma of the CNS consists of 2 major subtypes: secondary CNS involvement by systemic lymphoma (the most common) and PCNSL, in which the lymphoma is restricted to the brain, leptomeninges, spinal cord, or eyes, without evidence of it outside the CNS at primary diagnosis.

Primary central nervous system lymphoma (PCNSL) is a rare disease, accounting for 6% of all intracranial malignant tumors and 1-2% of all lymphomas.

Single or multiple periventricular and/or superficial contrast-enhancing lesions are characteristic of parenchymal CNS lymphoma.

CT and MR imaging techniques and, recently, metabolic imaging have demonstrated characteristic findings in CNS lymphoma, aiding in its differentiation from other CNS lesions.

 

A biopsy diagnosed PCNSL; the patient is dead two years after diagnosis, despite chemotherapy and radiotherapy treatment.

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