History of NK/T-cell lymphoma and bone marrow transplant as well as CNS involvement by post transplant lymphoproliferative disorder. Again seen are evolving chronic blood products, with evidence of retraction, and associated encephalomalacia in the right parieto-occipital region underlying the burr hole. Similarly, superficially located multifocal susceptibility effect from previous hemorrhages also remains. Confluent cerebral white-matter T2-hyperintensity, which is more pronounced on the right, also remains unchanged. There is no mass-effect, midline shift or brain herniation. Ex vacuo dilatation of the lateral and third ventricles have slightly increased and remains most pronounced in the posterior right lateral ventricle. No clear evidence of hydrocephalus.There is subtle contrast enhancement in the medial right occipital lobe, medial to the hemorrhage at the site of the previous lesion, as before, which is nonspecific in the setting of treatment changes in this region. Otherwise, there is no abnormal enhancement. Focal contrast enhancement involving the posterior aspect of the left insular cortex is resolved compatible with evolution of injury. Major intracranial vascular flow voids are preserved.The orbits are grossly unremarkable. There is moderate mucosal thickening in the paranasal sinuses associated with secretions in the maxillary sinuses. In the proper clinical setting, this may reflect acute or acute on chronic sinusitis.
1.No new mass or new enhancement to suggest disease progression. Subtle contrast enhancement in the right occipital lobe, medial to the evolving chronic blood products, is nonspecific in the setting of treatment changes in this region. 2.Evolving chronic blood products in the right parieto-occipital region with evidence of retraction. The other areas of signal abnormality indicative of previous multifocal hemorrhage remain unchanged. 3.Confluent cerebral white-matter T2-hyperintensity, which is more pronounced on the right, also remains unchanged and compatible with treatment change.4.Dilatation of the lateral and third ventricles is slightly increased and remains most pronounced in the posterior right lateral ventricle and likely reflective of volume loss. No clear evidence of hydrocephalus.