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| CT post-contrast | T1 post gad | T2 |
Diagnosis: Multicentric glioblastoma multiforme.
High grade astrocytomas (grades III & IV) usually arise in the white matter and make up 1/3 of all astrocytomas. They typically present in older patients (40-60) with seizures or focal neurologic deficit. They often have mixed signal characteristics and significant surrounding vasogenic edema. Calcification is uncommon. Metastases is probably the most likely diagnosis statistically, with multiple astrocytomas second. Abscesses could also look like this. CNS lymphoma is a consideration if the patient is immunocompromised since central necrosis is hardly ever seen in CNS lymphoma otherwise. Acute demyelination can mimick neoplasm and may be considered in the differential for ring enhancing lesions. Related Cases
