History of mycosis fungoides with CNS involvement treated with 2 cycles of Cytarabine/Etoposide in need of reimaging. Brain: There is a right transfrontal Ommaya catheter that terminates in the right lateral ventricle. There is no evidence of acute infarct. There is persistent diffuse enhancement of the cisternal segments of the bilateral trigeminal nerves and oculomotor nerves, left more than right. There also appears mild diffuse enhancement involving the bilateral facial nerves. There are mild nonspecific patchy areas of high T2 signal in the cerebral white matter bilaterally. The rest of the brain parenchyma appears to be unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Orbits: There is persistent, albeit slightly reduced, high T2 signal and mild hyperenhancement of the left inferior, medial, and superior oblique muscles. The high T2 signal in the right inferior recuts muscle is less conspicuous. The bilateral globes, lacrimal glands, and optic nerves are otherwise unremarkable.
1. Persistent enhancement of multiple cranial nerves related to lymphoma.2. Residual mild denervation edema in the extraocular muscles supplied by the left oculomotor nerve and to a lesser extent perhaps the right ocular motor nerve.