Diagnosis: Mantle cell lymphoma, lymph nodes of multiple sitesClinical question: assess for leptomeningeal lymphoma The CSF spaces are appropriate for the patient's stated age with no midline shift. There several subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Some enlarged perivascular spaces are present in the region of the basal gangliaNo abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a couple minor opacities The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits are intact.
1.There is no evidence for intracranial lymphoma or leptomeningeal disease.2.There are several subcortical white matter lesions present which are nonspecific and likely of little clinical significance as they are most likely simply age related.