 |  |  |
| T1 post-gad | T1 post-gad | T2 |
Diagnosis: Primary CNS lymphoma.
Primary CNS lymphoma usually presents after the age of 50 unless the patient is immunocompromised. Symptoms may include seizures or focal neurologic deficit. Primary CNS lymphoma enhances strongly is often hyperdense on non-enhanced CT and isointense to dark on T2 secondary to the increased cellularity of the tumor. It typically involves the corpus callosum, the periventricular white matter, and the basal ganglia. Hemorrhage and necrosis are unusual but may be seen if the patient is immunocompromised. Calcification is not a feature of lymphoma and it is avascular on angiography. Astrocytoma and metastasis are much less likely here particulary given the mostly periventricular distribution. Sarcoidosis may rarely present as a mass-like subependymal lesion. Related Cases
