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CNS LYMPHOMA RADIOLOGY
The document discusses the case of a 56-year-old male patient presenting with lesions in the brain. The top differential diagnoses listed are glioblastoma, primary CNS lymphoma, progressive multifocal leukoencephalopathy, and demyelination. Various MRI techniques are discussed for evaluating the lesions. After reviewing the imaging, the final diagnosis is determined to be primary CNS lymphoma, based on the characteristic enhancing lesion seen within the basal ganglia and periventricular white matter. Key features of primary CNS lymphoma on imaging and pathology are described.
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CNS LYMPHOMA RADIOLOGY
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- 2. • 56 yearold 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 CNSLymphoma
- 58. Malignant primary CNSneoplasm 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 seehemorrhage or necrosis in immunocompromised • DWI: Low ADC values • PWI: Low rCBV ratios
- 64. 24 year oldfemale 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 IntimalSarcoma
- 69. 10 year-old malepatient presents with near syncope and small volume hemoptysis.
- 74. 67-year-old male withenlarging left gluteal mass. Left buttock injury in MVA 25 years ago. Left buttock injury in a fall more recently
- 84.
- 85. A Morel-Lavallée lesionis a closed degloving injury associated with severe trauma which then presents as a haemolymphatic mass.