53-year-old male with lymphoma and persistent altered mental status. There is no evidence of intracranial hemorrhage or acute infarct. There is diffuse, mild, confluent, thin, high T2 signal along the bilateral ventricles, with a more focal area of increased T2 signal along the posterior horn of the left lateral ventricle. There is also a focus of increased T2 signal in the left cerebral hemisphere, which measures up to 8 mm. There is a right choroid fissure cyst. There is no abnormal intracranial enhancement. There is diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There are innumerable enhancing lesions distributed throughout the calvarium, which correspond to lytic lesions demonstrated on the prior CT. There is high T2 signal in the bilateral mastoid air cells, suggestive of effusions. The orbits and scalp soft tissues are grossly unremarkable.
1. Innumerable enhancing lesions throughout the skull are consistent with lymphoma.2. Small lesions in the left cerebellar hemisphere and left periventricular white matter are nonspecific, but may represent sequelae of treated central nervous system lymphoma, prior infection, or chronic ischemia.3. No evidence of intracranial hemorrhage or acute infarct.