PMC9610116_01
(a) Axial DWI shows no restriction of lesion. (b) Coronal T2 show high signal. (c) Sagittal T1 show high contrast uptake. (d) (Axial Flair) show high signal and (e) (Axial T1) show high contrast uptake
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F1
During the radiological investigation, magnetic resonance imaging (MRI) showed a solid tumor in the fourth ventricle with 1.8 x 1.6 x 1.1 cm of size and with the hyper signal on T2 and high contrast uptake on T1, however, with no diffusion-weighted imaging (DWI) restriction [Figure 1].
(a) (Axial T1), (b) (Sagittal T1), and (c) (Coronal T2) show the complete lesion resection.
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F2
After the surgery, the patient was submitted to a new MRI which showed complete tumor resection [Figure 2].
(a) (HE analysis) - shows big lymphocytic cells with hyperchromatic nuclei. (b-d) Show CD20, CD45, and Ki67 markers.
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F3
Immunohistochemistry showed positivity for CD-45, CD-23, and Ki67 in 90% of the cells which concluded the diagnosis of primary CNS lymphoma of the fourth ventricle [Figure 3].