Evaluate for recurrence of primary CNS lymphoma. There is redemonstration of extensive post-treatment changes of the left frontal lobe with regions of encephalomalacia and mild expansion of left frontal horn similar to prior exam. Mild signal changes of right anterior frontal lobe is also noted which as well remains stable. On the post enhanced images there is no detectable abnormal enhancement to suggest residual or recurrence of tumor. Slight prominence of cortical sulci similar to prior exam is again noted. Ventricular system remain slightly prominent. No midline shift.Multiple small patchy foci of flair hyperintensity in the periventricular and subcortical white matter of the bilateral cerebral hemispheres are redemonstrated and are nonspecific, but most likely representing chronic small vessel ischemic disease. Possibility of some overlapping posttreatment changes cannot be entirely excluded. Calvarium demonstrates post op changes but otherwise intact.
Post-treatment changes in the bilateral frontal lobes, left greater than right. No evidence of tumor recurrence. 