headache, lymphosarcoma (200.10) follow up Orbit MRI:The left intraorbital optic nerve demonstrate patch intermittent enhancement on post gadolinium imaging associated with about 5 to 6 mm thickening of optic nerve itself. These findings do not show any significant interval change since prior scan.Previously noted pre chiasmatic enhancing lesions (best seen on axial post-Gad images) within the optic canal bilaterally are also similar or slightly decreased since prior scan. However, cisternal segment of prechiasmatic bilateral optic nerves and chiasmatic enhancement are not definitely demonstrated on this scan. Thus, indicating interval improvement.The degree of proptosis appears to be stable.Brain MRI:No evidence of acute ischemic or hemorrhagic lesion on this scan.Linear high signal intensities on bilateral superior frontal gyrus on DWI are likely represent T2 shine through from superior frontal sulcus or an artifacts.There is no other abnormal enhancement except seen on orbit MRI on this scan. The ventricles, sulci and cisterns are symmetric and unremarkable.There is no edema, midline shift, intra- or extra-axial fluid collection, hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Opacifications and mucosal thickenings on the bilateral maxillary sinuses, ethmoid sinus and sphenoid sinus, left maxillary sinus opacification appears to be slightly improved but grossly there is no significant interval change since prior exam.
1. Interval improvement of pre-chiasmatic optic nerve (cisternal segment before it enters optic canal) and chiasmatic lesion since prior exam.2. No significant interval change of bilateral intra orbital optic nerve enhancement as well as the degree of the thickening of the left optic nerve since prior exam.3. No evidence of acute ischemic or hemorrhagic lesion.4. No abnormal enhancement on brain MRI except lesions seen on orbit MRI. 5. Pansinusitis, as described above.