Primary CNS lymphoma
Previously healthy. Presents with progressive headache and binocular visual blurring for three months. HIV negative.
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Heterogeneous hyperdense mass centered on the left caudate and lentiform nuclei. Medial extension to septum pellucidum. Posterior extension to left thalamus, prepontine and left ambient cisterns. The inferior part of the tumor compresses the optic chiasm.
Extensive perifocal edema over both cerebral hemispheres and through the left cerebral peduncle to the midbrain.
Left frontal burr hole from brain biopsy.
PET-CT: no other hypermetabolic masses evident.
Histology: diffuse large B-cell lymphoma.