Enhancing mass in the right frontal lobe, is, on pre-contrast T1/T2, mildly hypointense to gray matter with an area of central fluid signal. The solid component demonstrates several regions of low ADC signal with restricted diffusion noted anteriorly corresponding to a small satellite focus of nodular enhancement. Further separate linear focus of enhancement medially adjacent to the right caudate head/anterior limb internal capsule. Extensive surrounding high FLAIR/T2 signal extending into right cerebral peduncle/midbrain. Resultant positive mass effect with right lateral ventricle partial effacement and midline shift of 5 mm to the left. No hydrocephalus. Small foci of susceptibility artifact, which on phase imaging represent tiny focal haemorrhages. MR spectroscopy demonstrates elevated lactate peak, decreased NAA peak, and reversal of the choline to creatine ratio. The mass demonstrates low CBV compared to the adjacent abnormal white matter.
Findings are most in keeping with lymphoma.