CNS Lymphoma

Findings:

Multiple MR images demonstrate a heterogeneous lesion within the right parietal white matter associated with mass effect and patchy poorly defined enhancement. The diffusion and ADC map confirm restricted diffusion within the lesion. The lesion also demonstrates decreased T2 signal compatible with cellularity.

Discussion:

 

nHypointense T2 indicates a highly cellular lesion
nB lymphocytes
n90% supratentorial, BG or PVWM
nInitial response to steroids/XRT might be dramatic, but is short lived and overall prognosis still poor
nPCNSL imaging differs between immunocompetent and immunocompromised
nHomogenous solid enhancement in competent
nHeterogenous peripheral, ring enhancement in compromised
nVs toxoplasmosis- PCNSL is hypermetabolic on NM studies

 


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