Question:

Characteristic imaging findings of primary CNS lymphoma include all of the following except:
1. Restricted diffusion.
2. Isodense to hyperdense appearance on non contrast enhanced CT.
3. Increased enhancement after the administration of corticosteroids.
4. Hypointense to isointense appearance on T1WI.
5. Isointense to hyperintense on T2WI.





Answer:

The correct answer for the question "Characteristic imaging findings of primary CNS lymphoma include all of the following except:" is:

3. Increased enhancement after the administration of corticosteroids.



Explanation
1. [Due to the highly cellular nature of these tumors, there is often restricted diffusion making the lesions appear high intensity on DWI and hypointense on apparent diffusion coefficient (ADC).]

2. [The lesions appear as hyperdense or isodense on non contrasted CT.]

3. [PCNSL is sometimes referred to as a "ghost tumor" because corticosteroid administration has been reported to cause lesions to disappear or lose their contrast enhancement.]

4. [On MRI, the typical appearance of PCNSL is hypointense to isointense on T1-weighted images (T1WI).]

5. [On MRI, the typical appearance of PCNSL is isointense to hyperintense on T2-weighted images (T2WI).]



From the manuscript:
A Case of Intraventricular Primary Central Nervous System Lymphoma
Radiology Case. 2014 Mar; 8(3):1-8


This article belongs to the Neuro section.




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From the manuscript

A Case of Intraventricular Primary Central Nervous System Lymphoma

Free full text article: A Case of Intraventricular Primary  Central Nervous System Lymphoma

Abstract
We report a case of primary central nervous system lymphoma presenting as multiple intraventricular masses in an immunocompetent 68 year old man with severe headache and unsteady gait. The diagnosis was obtained by analysis of the cerebrospinal fluid and subsequent surgical biopsy. This is an unusual appearance for primary central nervous lymphoma, with the majority of the cases presenting as solitary masses.






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