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74 y/o F progressive dysarthria, dysphagia.

74 y/o F progressive dysarthria, dysphagia.

CT noncontrast 12/18/2008

12/29/2008

Axial FLAIR 12/30/2008

Axial T1 post Gad 12/30/2008

DWI

ADC map

MRS TE=270

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