MedPix® Patient Chart - Case No: 13381 :: Imaging - Review Images

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History

Age: 58 :: Gender: man

Patient History

58 year old man with 2 month history of personality changes and headache.

Exam


Physical Exam and Laboratory

Non-contributory


Imaging

Imaging - Review Images for PT: 13381

Findings


Summary of Findings

Expansile mass lesion involving the splenium of the corpus callosum. The mass enhances homogeneously and produces a moderate amount of surrounding vasogenic edema. The mass is not particularly bright on FLAIR and T2.


Imaging

Imaging - Review Images for PT: 13381

Diffferential


Differential Diagnosis

• Glioma (astrocytoma, oligodendroglioma, oligoastrocytoma
• Primary CNS Lymphoma
• Tumefactive Demyelination
» MS, ADEM, Marchiafava-Bignami Disease, etc.
• Infection (Abscess, encephalitis, ventriculitis)
• Metastatic disease


Imaging

Imaging - Review Images for PT: 13381

Diagnosis


Case Diagnosis

Dx: Diffuse Large B-Cell Lymphoma


Dx Confirmed by: Biopsy and pathologic examination

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Followup


Followup and Treatment

Radiation and chemotherapy

Discussion


Discussion for this Patient

The increased cellularity of "small round blue cell tumors" - like lymphoma - often has a characteristic imaging appearance of high attenuation on pre-contrast CT, low signal on T1 and T2 MR, and low ADC/high signal on DWI.

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Topic


Diffuse Large Cell Lymphoma

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Diffuse Large Cell Lymphoma

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History:
58 year old man with 2 month history of personality changes and headache.

Exam:
Non-contributory

Findings:
Expansile mass lesion involving the splenium of the corpus callosum. The mass enhances homogeneously and produces a moderate amount of surrounding vasogenic edema. The mass is not particularly bright on FLAIR and T2.

Differential:
• Glioma (astrocytoma, oligodendroglioma, oligoastrocytoma
• Primary CNS Lymphoma
• Tumefactive Demyelination
» MS, ADEM, Marchiafava-Bignami Disease, etc.
• Infection (Abscess, encephalitis, ventriculitis)
• Metastatic disease

Diagnosis:
Diffuse Large B-Cell Lymphoma
Confirmed by:Biopsy and pathologic examination

Treatment and Followup:
Radiation and chemotherapy

Discussion:
The increased cellularity of "small round blue cell tumors" - like lymphoma - often has a characteristic imaging appearance of high attenuation on pre-contrast CT, low signal on T1 and T2 MR, and low ADC/high signal on DWI.

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Case Contributor and Editor
Topic Author: Richard Conran
Submitted by: Steven J Goldstein - Author Info
Case/Image Editor: James G. Smirniotopoulos, M.D. - Editor Info
Case Accepted: 2010-01-12 13:22:56-05 :: Revised: :: Submitted:
COW: 507 :: CME Start: 20100114 :: CME End: 20110417 :: CME Review Due: 20130114
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