Primary CNS lymphoma (cerebellar)

Case contributed by Dr Derek Smith


Transfer from DGH to neurosurgical centre. Presented with few weeks of headache and reduced appetite. Worsening positional headache and new vomiting and dizziness. On examination, moderate cerebellar dysfunction (ataxia, poor alternating movements, dysdiadochokinesis).

Patient Data

Age: 65
Gender: Male


Large avidly enhancing left cerebellar mass. with local oedema.

Partial compression of 4th ventricle with moderate obstructive hydrocephalus.

No supratentorial masses or ischaemic areas. Normal calvarium and skull base.

For MR study.


MRI in specialist centre

Homogeneously enhancing, 35mm, solitary, left cerebellar infiltrative mass with mild mass effect and diffusion restriction.  Parenchyma otherwise returns normal signal.

CSF spaces are moderately prominent, with resolving hydrocephalus.

Case Discussion

The patient received steroids prior to transfer to the neurosurgical centre.

He underwent decompressive resection of the tumour. The post-operative recovery was uneventful.

Pathology returned diffuse large B-cell lymphoma. There was no evidence of other malignancy on investigation and HIV serology was negative.

Chemoradiotherapy was delivered and follow up cerebral MR at three months showed no evidence of recurrence.

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Case information

rID: 33744
Published: 22nd Jan 2015
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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