ADVANCED MRI IN CNS LYMPHOMA

1. RENAI RADIOLOGY
RENAI MEDICITY

2. • 56 year old male patient

20. TOP DIFFERENTIAL DIAGNOSIS
• Acquired toxoplasmosis
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Abscess
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

22. • DWI
• PERFUSION
• CONTRAST ENHANCED SCANS
• GRADIENT IMAGING
• DIFFUSION TRACTOGRPHY
• MR SPECTROSCOPY
• Arterial Spin labelling

23. TOP DIFFERENTIAL DIAGNOSES
• Acquired toxoplasmosis
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Abscess
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

24. TOP DIFFERENTIAL DIAGNOSES
• Acquired toxoplasmosis
• Abscess

34. TOP DIFFERENTIAL DIAGNOSES
• Acquired toxoplasmosis
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Abscess
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

35. TOP DIFFERENTIAL DIAGNOSES
• Acquired toxoplasmosis
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Abscess
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

36. TOP DIFFERENTIAL DIAGNOSIS
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

37. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

44. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

45. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma
• Progressive multifocal leukoencephalopathy (PML)
• Demyelination

46. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma

55. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma

56. TOP DIFFERENTIAL DIAGNOSES
• Glioblastoma (GBM)
• Primary CNS Lymphoma

57. DIAGNOSIS
• Primary CNS Lymphoma

58. Malignant primary CNS neoplasm primarily composed of B Lymphocytes.Disease
outside the nervous system is absent at the time of Dx.
IMAGING
• Best diagnostic clue: Enhancing lesion within basal
ganglia &/or periventricular white matter
• Often involve/ cross corpus callosum
○ Frequently contact, extend along ependymal surfaces
• Classically hyperdense on CT (helpful for diagnosis)
• Diffusely enhancing periventricular mass in immunocompetent

59. • May see hemorrhage or necrosis in immunocompromised
• DWI: Low ADC values
• PWI: Low rCBV ratios

64. 24 year old female was treated over the last three
months for a pulmonary embolism diagnosed at
an outside hospital. She has experienced
increasing dyspnea and recently hemoptysis and a
syncopal episode
C/P

68. Pulmonary Artery Intimal Sarcoma

69. 10 year-old male patient presents with near
syncope and small volume hemoptysis.

74. 67-year-old male with enlarging left gluteal mass. Left buttock
injury in MVA 25 years ago. Left buttock injury in a fall more
recently

84. Morel-Lavallee lesion

85. A Morel-Lavallée lesion is a closed degloving injury associated with
severe trauma which then presents as a haemolymphatic mass.