Primary CNS lymphoma

Case contributed by Dr Ammar Haouimi

Presentation

Had open biopsy for brain tumor one month ago. Previous brain CT/MRI not available. No history of immunocompromised state or co-existing systemic disease.

Patient Data

Age: 40 years
Gender: Male
CT

There is a large intra-axial mass of right occipitoparietal location, extending through the adjacent craniotomy. It appears spontaneously iso-to hyperdense to the cortical grey matter with homogeneous vivid enhancement except for the central hypodense necrotic areas (probably post-biopsy). The adjacent portion of the superior sagittal sinus is most likely invaded. Surrounding vasogenic edema is noted as well as a mass effect on the right trigone with midline shift.

Case Discussion

CT features of a supratentorial intra-axial mass spontaneously iso-to hyperdense to the cortical grey matter with homogeneous vivid enhancement in a patient with no co-existing systemic disease, suggest a primary CNS lymphoma which was confirmed on histopathological exam with immunochemistry as a diffuse large B-cell lymphoma.

 

Additional contributor: ZE. Boudiaf, MD, CHU Constantine

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