Primary CNS lymphoma
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Patchy nodular regions of enhancement are seen in the left frontal lobe as well as beside the lateral ventricles, including the corpus callosum.
The patient went on to have a biopsy.
Sections show small fragments of brain tissue which are diffusely infiltrated by reactive and atypical lymphoid cells. The atypical cells have pleomorphic round nuclei with little visible cytoplasm and show immunoreactivity for the B-cell marker CD20. A smaller population of normal appearing CD3 positive reactive T-lymphocytes is also present. The atypical cells show prominent mitotic activity and there are focal areas of necrosis. Reticulin stain highlights the perivascular and intravascular pattern
FINAL DIAGNOSIS: Features are those of lymphoma. In the absence of systemic disease, the diagnosis is primary CNS lymphoma.