PMC10408608_01
Brain axial computed tomography shows (a and b) multiple supratentorial enhacing lesions associated with edema causing effacement of adjacent sulci. (c) The largest lesion in the right parietal lobe 2.1 x 1.8 x 1.5 cm.
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F1
A cranial CT scan was performed, which indicated multiple supratentorial lesions [Figure 1].
Brain magnetic resonance imaging (a) axial (b) coronal section intermediate T2 signals shows multiple enhaced scattered mass lesions involving the right frontal and occipital lobes. (c) Axial (d) coronal section shows largest lesion in the right temporal lobe measures 2.3 x 1.9 x 2.0 cm.
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F2
The patient was then advised to undergo multisequence intravenous contract brain magnetic resonance imaging (MRI), which revealed lesions located in the right frontal and occipital lobes [Figure 2].
(a and b) H&E stained sections show diffuse sheets of large neoplastic cells with round nuclei that exhibit vesicular chromatin and prominent central nucleoli to membrane bound multiple nucleoli. Mitotic figures are seen. (c) Immunohistochemistry shows large cells with positive for CD20, CD30, BCL6, MUM1, and C-MYC (40%), while negative for BCL2 and CD23. (d) Immunohistochemistry shows Ki67 proliferative index that is positive in 80% of tumor cells.
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F3
Mitotic figures were observed [Figure 3].
Follow-up postsurgical magnetic resonance imaging (a) axial (b) coronal section shows occipital lesions very small to measure. (c) Axial section shows resolution of the right temporal lesion. (d) Coronal section shows craniotomy site right frontal meningeal enhancement.
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F4
The MRI scan indicated that the right frontal lymphomatous lesions had resolved and that there had been a reduction in the size of the other lesions [Figure 4].