72 year old male patient with CNS lymphoma status post therapy. Patient is in CR, restaging examination. There is redemonstration of post-treatment changes in the left frontal lobe with regions of encephalomalacia and mild expansion of left frontal horn similar to the prior exam. Mild signal changes of right anterior frontal lobe is also noted which remains stable. On the post enhanced images, there is no detectable abnormal enhancement to suggest residual or recurrence of tumor. There are no diffusion-weighted abnormalities to suggest acute ischemia. Multiple small patchy foci of flair hyperintensity in the periventricular and subcortical white matter of the bilateral cerebral hemispheres and pons are redemonstrated and likely represent chronic small vessel ischemic disease. There is a tiny 6 mm focus of enhancement within the anterior falx cerebri, which remains unchanged from prior studies, and exerts no surrounding mass effect. There is no midline shift or herniation. The ventricular system is stable in size and configuration. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are unchanged.
1. Post-treatment changes in the bilateral frontal lobes without evidence of tumor recurrence.2. Subcentimeter focus of enhancement along the anterior falx cerebri remains unchanged and likely represents a tiny meningioma and remains unchanged. No evidence of intracranial mass effect.