Neuro_MR_Brain: 70 M, follicular lymphoma, AMS.

MRI BRAIN WITH AND WITHOUT CONTRAST:

 

CLINICAL HISTORY: 70-year-old male with follicular lymphoma with new neurologic symptoms evaluate for lymphomatous meningitis versus mass.

 

FINDINGS:

 

Parenchyma: There is mild diffusion restriction surrounding the bilateral lateral ventricles as well as within the bilateral hypothalamic structures involving infundibular recess with 

questionable thickening of the base of the infundibulum. There is mild diffuse ependymal enhancement. There is also an apparent mass within the right lateral ventricle which appears contiguous with the choroid plexus, demonstrates contrast enhancement and mild diffusion restriction.

 

There are stable postsurgical findings from a right frontal biopsy with likely some blood products at the biopsy site. There is mild 

enhancement at the biopsy site which may be reactive. There is no abnormal signal or enhancement within the subarachnoid space of the basal cisterns or over the convexities.

 

The ventricles are stable in size. No layering debris is seen within the dependent ventricles.

 

Old cerebellar injury is again seen.

 

Orbits: Normal.

 

Visualized paranasal sinuses: Clear.

 

Mastoid air cells: Clear.

 

Bones: Normal.

 

Additional comment: None.

IMPRESSION:

 

1.  Diffuse periventricular signal abnormality with mild ependymal enhancement and mass lesion within the body of the right lateral ventricle. This suggests CNS involvement by patient's known systemic lymphoma. There is no enhancement or signal abnormality in the subarachnoid space over the convexities or within the basal cisterns. Thickening of the infundibulum may represent disease within the infundibular recess.

 

2.  Evolution of post surgical findings from right frontal biopsy.

(Follicular lymphoma involving CNS)