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Case #35

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Demographics: 74 years old, Female
Indication: Altered mental status

Case #35

Findings

CT

  • Areas of hypoattenuation in the right greater than left lentiform nuclei, internal capsules, and thalami with extension into the bilateral cerebral white matter

MRI

  • Relatively symmetric T2/FLAIR signal hyperintensity most pronounced in the supratentorial deep gray nuclei and deep white matter, including the internal capsules and corpus callosum, with associated curvilinear and nodular enhancement in a perivascular distribution
  • Patchy corresponding restricted diffusion
  • No midline shift or evidence of herniation or hydrocephalus

Diagnosis

Intravascular lymphoma

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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