CNS lymphoma, evaluate for recurrence: fatigue. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is a right transfrontal Ommaya catheter that terminates in the right lateral ventricle. There is a cystic cavity in the surrounding right frontal lobe parenchyma that measures up to 31 mm. The ventricles and basal cisterns are unchanged in size and configuration, with mild diffuse cerebral volume loss. There is mild diffuse periventricular white matter T2 hyperintensity. There is no midline shift or herniation. The major cerebral flow voids are intact. There is persistent high T2 signal and enhancement in the clivus, with prominent trabeculae. There is mild left maxillary sinus mucosal thickening.Orbits: There is persistent mild diffuse enhancement along the bilateral optic nerve sheaths, but otherwise no evidence of intraorbital mass lesions. There are bilateral staphylomatous globe deformities and a left lens implant. Spine: There is persistent mild enhancement along multiple cauda equina nerves roots diffusely and along the surface of portions of the thoracic spinal cord. The spinal cord otherwise displays normal signal and morphology. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is degenerative spondylosis involving multiple levels of the lower lumbar spine with inflammatory changes in multiple facet joints, but no significant spinal canal or neural foraminal stenosis. Aside from degenerative signal alterations, the vertebral bone marrow signal is unremarkable. However, there is persistent signal abnormality in the bilateral iliac bones. The paravertebral soft tissues are unremarkable.
1. No evidence of intracranial tumors.2. Cavitation surrounding the right transfrontal Ommaya catheter may represent sequela of necrosis.3. The ventricles are unchanged in size. 4. Persistent mild diffuse enhancement along the bilateral optic nerve sheaths, which may be related to lymphoma or represent perineuritis, but otherwise no evidence of intraorbital mass lesions.5. Persistent mild enhancement along multiple cauda equina nerves roots diffusely and along the surface of portions of the thoracic spinal cord likely related to lymphoma.6. Nonspecific persistent abnormality in the clivus and iliac bones.7. Multilevel degenerative spondylosis in the lower lumbar spine, with inflammatory facet arthropathy.