4/2018

6/2018

Lymphoma, primary, L IAC

Findings:

Multiple MR images demonstrate diffuse somewhat uniform thickening and enhancement of the left 7th/8th nerve complex extending to the geniculate ganglion. This process is significantly progressive in 2 months, with more infiltrative appearing enhancement extending more medially to the root entry zone, and progressive neural thickening as is best demonstrated on the FIESTA sequence.

Discussion/Differential Diagnosis:

On the initial study, the differential diagnosis is relatively broad, including infiltrative metastatic or primary neoplasm and inflammatory process. The lack of nodularity makes schwannoma unlikely. The rapid progression with infiltration raises the possibility of primary or metastatic malignant process such as lymphoma. Primary lymphoma of the IAC is rare. Some references are listed below:

Primary Central Nervous System Lymphoma Presenting as Bilateral Tumors of the Internal Auditory Canal

Lymphoma of the Internal Auditory Canal Presenting as Facial Palsy, Vertigo, and Hearing Loss

Lymphoma of the internal auditory canal presenting as facial palsy, vertigo, and hearing loss

Primary Lymphoma of the Internal Auditory Canal Case Report and Review of the Literature

CP angle masses RP correlation

Case contributed by Dr. Sheri Brinker, UC Neuroradiology Fellow 2018-19.

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