PMC6904776_01
Brain MRI showing multiple enhancing brain lesions including a 0.7-cm right
superior anterior cerebellar parenchymal lesion (A, arrow), 0.3-cm and
0.2-cm left paramedian cerebellar vermian lesions (A, dashed arrow), a
1.9-cm superior right cerebellar lesion with mass effect and surrounding
vasogenic edema causing partial effacement of the right aspect of the fourth
ventricle (B), and a 0.2-cm left thalamic lesion (C, arrow).
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A follow-up brain magnetic resonance imaging (MRI) showed multiple posterior fossa enhancing lesions and an additional punctate enhancing lesion in the left thalamus, suspicious for metastatic carcinoma (Figure 1).
Brain biopsy showing a cellular infiltrate with necrosis and perivascular
preservation (A) composed of large lymphoid cells with centralistic
morphology and numerous apoptotic bodies (B), immunoreactive for CD-20 (C),
Bcl-6 (D), and CD-10 (E) consistent with a DLBCL of germinal center
phenotype. The lymphoma exhibited a high proliferation index (>95%).
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Histopathology of the specimen showed a DLBCL positive for CD20 and CD10 with a Ki67 proliferative index greater than 95% (Figure 2).
Brain MRI after 6 cycles of chemotherapy completion showing interval
resolution of the multiple enhancing lesions in the posterior fossa. No
evidence of residual or new foci of primary CNS lymphoma.
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A follow-up brain MRI showed interval resolution of the multiple enhancing lesions in the posterior fossa, with no evidence of residual or new foci of primary CNS lymphoma (Figure 3).