23 years, Male, Reason: 23 year old with Primary Med. DLBCL with mets to brain now s/p 2 cycles HD MTX and Cytarabine in need of reimaging. There has been marked decrease in size of previously seen enhancing mass in the left occipital lobe as well as a decrease in surrounding vasogenic edema. There are postsurgical changes of left occipital craniotomy for biopsy with blood products at the site of the left occipital lesion with mild residual enhancement. Lesion previously 27 x 23 x 26 mm, now measures approximately 18 x 10 x 16 mm in the maximal AP, transverse, and craniocaudal dimensions, although note current maximal measurements include the central nonenhancing postsurgical change, while there was more solid enhancement on the preoperative study.There are blood products within the left occipital resection cavity as mentioned above as well as a punctate microhemorrhage in the left parietal deep white matter just anteriorly. No abnormal parenchymal or meningeal enhancement elsewhere in the brain. No evidence of acute ischemia. No evidence of intracranial mass effect, midline shift, or herniation. Ventricles are normal in size. Right maxillary mucus retention cyst is again seen. Aside from the left parieto-occipital postsurgical changes, calvarium and extracranial soft tissues are grossly unremarkable.
Significant decrease in size of left occipital mass and surrounding edema. Residual enhancing lesion as above. No new lesions.