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CNS lymphoma

Case contributed by Frank Gaillard
Diagnosis certain

Patient Data

Age: 60 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

MRI head

mri

Multiple periventricular regions of vivid contrast enhancement, which are low on T2 and surrounded by relatively little edema. They also demonstrate restricted diffusion in keeping with a highly cellular tumor. Features are characteristic of CNS lymphoma. 

Histology

pathology

MICROSCOPIC DESCRIPTION:

The sections show a densely cellular malignant tumor in the  white matter. It forms diffuse sheets and cuffs around the blood  vessels. The tumor cells are intermediate in size. They have enlarged  clefted and hyperchromatic nuclei, prominent nucleoli and scanty  cytoplasm. The tumor cells are CD20, PAX-5, bcl-2, bcl-6 and MUM1  positive. The Ki-67 index is about 80%. They are CD3 and CD10  negative. There is insufficient tissue for EBER-CISH. The features are  those of diffuse large B-cell lymphoma with activated B-cell-like  phenotype.

DIAGNOSIS:

Diffuse large B-cell lymphoma.

Case Discussion

This is a typical radiological appearance of CNS lymphoma, and the diagnosis can be suggested with a high degree of certainty. 

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