Presentation
75-year-old female reporting abdominal lymphoma which was treated 10 years previously. Presented with altered sensory perception and weakness.
Patient Data
Altered signal intensity lesions in bilateral parieto - occipital periventricular region and splenium/posterior body of corpus callosum, with associated ependymal thickening and peri lesional edema ; and displaying Iso- hypointense signals on T1 WI getting Iso- hyperintense on T2WI with areas on diffusion restriction in splenium of corpus callosum. No areas of GRE blooming to suggest bleed.
On CEMR, the lesions show heterogeneous nodular ependymal enhancement in posterior periventricular and splenium/posterior body of corpus callosum regions.
Case Discussion
Biopsy proven secondary CNS Lymphoma.
Secondary CNS Lymphoma is commonly a non-Hodgkin's lymphoma and is secondary to lymphoma in other parts of the body.
Leptomeningeal enhancement is commoner in secondary lymphomas, as in this case (as compared to the parenchymal disease).
Lymphomas are usually hypercellular and display areas of restricted diffusion.
Differential diagnosis includes: glioma, abscess, demyelinating lesions, metastasis, ependymitis and sarcoidosis.
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