Lymphoma: vision changes. Brain MRI: There is further decrease in size and enhancement associated with the right lateral and central skull base tumor with extracranial and intracranial soft tissue components since April 2016. There is a right transfrontal ventricular catheter that terminates in the right lateral ventricle. There is mild T2 hyperintensity surrounding the catheter in the right frontal lobe. There is slight interval enlargement of the right lateral ventricle, which is otherwise narrower than the left lateral ventricle. There is no evidence of intraparenchymal tumors or acute infarction. There is no midline shift or herniation. There are persistent right mastoid effusions. There are persistent enhancing lesions within the bilateral mandibular condyles and left medial temporal bone.Brain MRV: There is a persistent filling defect in the right sigmoid sinus and jugular bulb. There is narrowing of the upper right internal jugular vein. The rest of the cerebral venous sinuses are intact.Orbit MR: There is decreased prominence of the optic nerve discs and dilatation of the optic nerve sheaths. The orbital contents are otherwise unremarkable bilaterally.
1. Slight interval increase in size of the shunted right lateral ventricle.2. Further decrease in size and enhancement associated with the right lateral and central skull base tumor with extracranial and intracranial soft tissue components, likely attributable to treatment effects. 3. Decreased prominence of the optic nerve discs and dilatation of the optic nerve sheaths since April 2016, likely indicating lower intracranial pressure. 4. Persistent thrombus in the right sigmoid sinus and jugular bulb. 5. Persistent enhancing lesions within the bilateral mandibular condyles and left medial temporal bone likely represent additional lymphoma deposits.