74 Y/O F Progressive Dysarthria, Dysphagia

This is unpublished
CT noncontrast 12/18/2008.
CT noncontrast 12/18/2008
12/29/2008.
12/29/2008
Axial FLAIR 12/30/2008.
Axial FLAIR 12/30/2008
Axial T1 post Gad 12/30/2008.
Axial T1 post Gad 12/30/2008
DWI.
DWI
ADC map.
ADC map
MRS TE=270.
MRS TE=270
MR perfusion CBV map.
MR perfusion CBV map

Findings:

Multiple enhancing mass lesions with increased choline and restricted diffusion and minimally decreased perfusion

DDX:

Metastases, abscesses, lymphoma, demyelination

Diagnosis:

CSF analysis shows large cell B cell lymphoma.

Discussion:

Lymphoma with high cellularity may show restricted diffusion and iso or slightly decreased perfusion.

Submitted by Paritosh Khanna, MD, UW Neuroradiology Fellow