Reason: left eye proptosis with hx of CNS lymphoma History: left eye proptosis and pain Exam is severely degraded by motion artifact.There is interval progression of the circumferential soft tissue thickening involving the left intraorbital optic nerve measuring up to 6-mm in thickness. There is also increase in T2 signal abnormality of this lesion. There is interval improvement of the previously seen pre-chiasmatic and chiasmatic component with mild residual enhancement of the right prechiasmatic optic nerve centered at the optic canal and left optic nerve just anterior to the chiasm and intracanalicular portion. There is worsening of left orbital proptosis. Additional lesions of the brain seen on prior studies are suboptimally evaluated on this study.There is moderate diffuse paranasal mucosal thickening, similar to prior study. There is no significant interval change in the size of the ventricular system. There is no midline shift or herniation. The skull and scalp soft tissues are unremarkable.
1.Compared to MRI 2/11/2015, there is interval increase in circumferential soft tissue surrounding the left intraorbital optic nerve suspicious for some disease progression. There is worsening proptosis. 2.Limited exam from motion artifact. There is interval improvement of prechiasmatic and chiasmatic abnormal enhancement with residual disease as described above. Consider dedicated MRI of the brain with contrast to follow up intracranial extent of disease as clinically indicated.3.Moderate diffuse paranasal mucosal thickening similar to prior study.