Medcyclopaedia Home E-learningLibraryLexical IndexLexical TopicsGlossaryFace-a-CaseSpinal CordCerebral TumorsCystic TumorsEmbryonal TumorsLocal Extension From Regional TumorsLymphomas And Hematopoetic NeoplasmsMeningeal And Mesenchymal TumorsMetastatic TumorsNeural And Mixed Neural Glial TumorsPineal Region TumorsPseudotumoral LesionsTumors Of Neuroepithelial TissueMR Neuro AngiographyTextbook of RadiologyTextbook of Radiology (e-paper)Medical Imaging Made EasyDownloadsMedcyclOasisAbout MedcyclopaediaContact Us
MedcycloPoll
Did you get the help you required from Medcyclopaedia™ during today's visit?
Yes
 
 (84.6%)
No
 
 (10.9%)
Undecided
 
 (4.5%)
You must be logged on to vote.
Please log in or register.
 
 
 

Primary non-Hodgkin lymphoma of the brain, case 2

CLINICAL HISTORY:
This 70-year old man suddenly experienced a feeling of warmth in the left temporal region, accompanied by paresthesias in the left arm and hand. He progressively developed diplopia, fatigue and weakness in the left arm and leg.

NEUROLOGICAL EXAMINATION shows a positive Romberg test with a tendency to fall to the left. There is a slight left hemiparesis.

CT:
a) NON-CONTRAST SCAN (IMAGE 1): Midline shift to the left is seen associated with a ring-like mass (arrowheads) in the right hemisphere, with surrounding edema.

b) CONTRAST-ENHANCED SCAN (IMAGE 2): Ring-like enhancement is noted (arrowheads), with nodular appearance of the inner wall.

MRI:
a) TRANSAXIAL T2-WEIGHTED (2800/53) SPIN-ECHO SEQUENCE (IMAGE 3) confirms the mass (arrowheads) with peripheral isointensity to grey matter and central hypointensity. Surrounding edema is identified.

b) TRANSAXIAL T1-WEIGHTED (512/4) SPIN-ECHO SEQUENCE (IMAGE 4): The mass (arrowheads) is inhomogeneous.

c) TRANSAXIAL (IMAGE 5), CORONAL (IMAGE 6) AND SAGITTAL (IMAGE 7) GADOLINIUM-ENHANCED SPIN-ECHO SEQUENCES: The mass shows moderate to intense contrast enhancement, with ring-like irregular appearance of the inner wall. Note the suprasylvian location of the tumor is appreciated (arrowheads point to Sylvian fissure).

RADIOLOGICAL DIFFERENTIAL DIAGNOSIS: is malignant tumor, such as anaplastic astrocytoma or glioblastoma. Lymphoma is another possibility, but is not likely, due to its rarity.

SURGICAL FINDINGS: At surgery, the tumor was blue-greyish and soft, poorly delineated and moderately vascular. The center of the tumor was filled with clear yellow fluid. The tumor extended down to the Sylvian fissure. Resection was partial and treatment completed with radiotherapy.

ANATOMOPATHOLOGY (IMAGE 8) was consistent with large cell non-Hodgkin lymphoma.
IMAGE 8 illustrates a postmortem coronal slice of a patient with a right tempero-occipital location of lymphoma. Notice the hemorrhagic character.

FOLLOW-UP: The patient died within 2 months after treatment.

Search also:
Primary CNS lymphoma

 

The ESNR CD-Rom Series

To view high resolution images,
please register first.

Click  here to register.

Already registered? Enter your e-mail in the window below.
Re-register

Fig. 1

Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 1
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 2
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 3
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 4
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 5
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 6
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 7
Primary non-Hodgkin lymphoma of the brain, case 2, Fig. 8