PMC4942274_01
(A) At diagnosis: contrast-enhanced axial T1-weighted image through the centrum semiovale shows a large enhancing mass in the deep left hemisphere, with surrounding edema. (B) Relapsed images of patient: contrast-enhanced axial T1-weighted image shows progressive increase in the size of the deep left hemispheric mass. Multiple new enhancing tumor nodules have developed in both cerebral hemispheres (arrows), most appear cortically based. (C) Most recent MRI: contrast-enhanced axial T1-weighted image reveals essentially complete resolution of the deep left hemispheric mass, with development of cystic encephalomalacia in the region. All of the previously documented enhancing nodules have also resolved.
nihms797228f1.jpg
PMC4942274_01_nihms797228f1.jpg
F1
There were also multiple new enhancing T2 bright lesions in the gray matter of the cerebral hemispheres bilaterally (Figure 1).
(A) A high-power hematoxylin and eosin-stained section showing a dense atypical lymphoid infiltrate involving the white matter with admixed numerous macrophages. The lymphoid cells are relatively small, with condensed chromatin and mild cytologic atypia (400x). By immunohistochemistry the majority of the infiltrate is composed of T cells expressing CD8 (B) (400x), with partial expression of CD5 (C) (400x). (D) Molecular studies revealed clonal rearrangement for the T-cell receptor gamma locus using a single multiplexed PCR reaction.
nihms797228f2.jpg
PMC4942274_01_nihms797228f2.jpg
F2
TCR gamma and beta F1 (Figure 2). This has been reported in other, both EBV negative and positive.