Presentation
Seizures and headache for 2 weeks, underlying retroviral infection.
Patient Data
CT demonstrates hyperdensity supratentorial lesions with homogenous post-contrast enhancement in the subependymal region and crossing the corpus callosum. No central necrosis or calcifications. Associated vasogenic edema with effacement of surface sulci at the vertex. No acute hydrocephalus or downward herniation.
Axial image with the blue arrow pointing to the homogenously enhancing lesion crossing the splenium and body of the corpus callosum to the contralateral side. The red arrow denotes the subependymal location of lymphoma. No significant hydrocephalus.
The patient had chemoradiation with marked interval improvement and complete resolution of previously noted hyperdense homogenously enhancing subependymal and callosal lymphoma. Right frontal Burr hole noted.
Case Discussion
The case demonstrates the classic appearance of primary CNS lymphoma. The patient had a surgical biopsy with histopathological confirmation. No co-existing systemic disease was evident at the time of diagnosis. Subsequently, the patient received chemoradiation. Differential for corpus callosal lesion includes butterfly glioma/glioblastoma, radiation changes, demyelination and metabolic causes.