Primary CNS lymphoma. Status post chemotherapy and stem cell transplant. Worsening right ocular ptosis. There is no acute infarct or acute intracranial hemorrhage. The confluent and patchy T2-hyperintense signal involving the periventricular and deep cerebral white-matter is not significantly changed since the previous examination. Similar involvement is present in the lateral aspect of the left cerebellar hemisphere. The frontal horn of the right lateral ventricle remains small while the remainder of the ventricular system as well as the other CSF-containing spaces remain enlarged reflecting underlying brain volume loss. There is no contrast-enhancing or space-occupying brain lesion. The cavernous sinuses are symmetric and the Meckel's caves are preserved. There is no abnormal leptomeningeal enhancement.There is mild anterior ethmoid sinus mucosal thickening. There are changes of previous bilateral cataract surgery but the orbits are otherwise unremarkable. There is no definite destructive skull lesion.
1.There is no new intracranial contrast enhancement or mass to suggest tumor recurrence.2.There is no acute infarct or intracranial hemorrhage.3.Unchanged brain white-matter abnormality perhaps representing a combination of sites of prior lymphomatous disease and some superimposed posttreatment change or chronic microvascular ischemia.