Unusual primary central nervous system lymphoma location involving the fourth ventricle and hypothalamus

Abstract

A previously healthy 65-year-old man presented with a two-week history of weight loss, headaches, blurred vision, asthenia and quickly worsening walking impairment. He denied photophobia, neck stiffness, fever, nausea or vomiting.Neurological examination showed global motor slowing, tendency to fall asleep during the clinical examination, generalized weakness against resistance to head and limbs, and osteotendon reflexes present in the upper limbs, but not evoked in the lower limbs. No sensitive deficit or focal neurologic sign was recognizable.Non-contrast multislice computed tomography (MSCT) of the head was performed in the emergency department, showing diffuse periventricular white matter and thalamic mild hyperdensity.Lumbar puncture, blood tests, including serology for HIV and other infections, were negative.On the third day the patient, showing decreased consciousness, underwent magnetic resonance imaging (MRI) with contrast medium injection. MRI revealed the presence of multiple pseudonodular avidly enhancing lesions, supra and infratentorial, crossing the midline, involving the ventricular system, including the fourth ventricle, with extension into the surrounding white matter, the corpus callosum, the thalamus and the hypothamalus.A stereotactic biopsy led to a diagnosis of diffuse large B-cell lymphoma, primarily located in the central nervous system (PCNSL).After the completion of the first phase of treatment (immunotherapy with intravenous Rituximab and corticosteroid), the MRI showed a marked regression of tumor masses.

Segmentation procedures for the assessment of paranasal sinuses volumes

“…A relatively new application of CT segmentation is represented by the elaboration of 3D surface-shaded reconstruction showing the bone involvement of sinonasal anomalies 42 and 3D printed anatomical models (Figure 8), suitable for education and didactics for otolaryngology and radiology residents, 43–46 to prepare surgeons to approach intracranial lesions. 47 The combination of virtual reality and 3D-printed models is feasible and may represent a useful educational tool.…”

Meningioma with ring enhancement on MRI: a rare case report

“…Even if contrast-enhanced brain CT provide useful information of intracranial disorders, enhanced brain MRI represents the gold standard technique for the assessment and characterization of malignant and benign lesions [ 7 ]. Common ring-enhancing intracranial lesions include glioblastoma, brain abscess and metastatic tumour.…”

Nasal cavities and the nasal septum: Anatomical variants and assessment of features with computed tomography

“…These are mainly based on segmentation procedures to produce an anatomically precise model derived from CT and magnetic resonance imaging (Figure 10). [40][41][42] One critical step is the segmentation of the nasal cavities from imaging data sets. The anatomical complexity of these structures and the extensive connection to other airway components, such as the ethmoid sinuses and the pharynx, makes the segmentation of the only nasal cavity difficult without the manual intervention of an experienced operator.…”