Male 72 years with blindness and history of lymphoma. MRI Brain:Exam is severely limited by motion. There is prominent restricted diffusion, masslike FLAIR signal abnormality and intense enhancement extending across the splenium with extension into the parietal, occipital and posterior temporal lobes bilaterally. There is evidence of recent biopsy via right parieto-occipital approach. There is question of increased vascularity and/or leptomeningeal enhancement in the medial parieto-occipital region as well as along the left temporal horn, not adequately assessed given the severe motion degradation.No gross evidence of acute infarct or hemorrhage. There is mild periventricular and subcortical white matter T2/FLAIR hyperintensity, which is nonspecific but likely related to chronic small vessel ischemic disease.There is no significant midline shift or herniation. No hydrocephalus.MRI Orbits:Severely limited exam. Postcontrast sequences could not be obtained. No obvious mass within the orbits is appreciated. No gross signal abnormality involving the optic nerves. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen.
1. Infiltrative mass extending across the splenium of the corpus callosum and involving the bilateral parietal, occipital, and posterior temporal lobes is consistent with lymphoma. 2. There is suggestion of abnormal leptomeningeal enhancement in the medial parietal-occipital regions as well as along the left temporal horn surface which is not adequately evaluated due to motion degradation but raises possibility of leptomeningeal disease. Follow-up imaging with sedation or correlation with CSF sampling is suggested.3. No obvious orbital lesion is appreciated. Please see comment in technique section.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.