Clinical question: Please evaluate lesion. Concern for CNS lymphoma. Signs and symptoms: Headaches, nausea and vomiting, history of lymphoma. Pre-and postcontrast CT of brain:Examination demonstrate an enhancing mass wave a small area of internal necrosis measuring 25.5-mm x 22 0.2-mm in the inferior right frontal lobe. There is evidence of surrounding vasogenic edema. Very minimal midline shift at the level of floor of anterior cranial fossa.A is a provided clinical date of findings is believed to represent CNS lymphoma. This finding was not present on prior MRI examination from 2007.Small punctate focus of high density measuring approximately 3 mm times 2-mm in deep right frontal periventricular white matter is noted. Finding may represent calcification although its small size makes precise evaluation difficult and the possibility of a small hemorrhage cannot be entirely ruled out although this latter possibility is considered less likely.This examination is otherwise unremarkable.Calvarium, mastoid air cells and limited view of paranasal sinuses are unremarkable.90 cc of Omnipaque 350 is administered for above study.
1.Enhancing mass in the inferior aspect of right frontal lobe with surrounding vasogenic edema may represent recurrence of CNS lymphoma.2.Small focus of calcification measuring approximately 3 mm in deep periventricular white matter of right frontal lobe of uncertain significance.3.Unremarkable study otherwise.