Lymphoma - Response to Radiotherapy

A 35 yo pt with a hyper dense uniform enhnacing right basal ganglionic lesion with marked perilesional odema. Mass effect. Possible DDs suggested were : Toxoplasmosis and Lymphoma. 

Pt was non reactive in TRIDOT test done for evaluation of immune status. 

Did not responded for initial course of antibiotics.

Subjected for Radiotherapy. 

The follow up CT study during the initial course of Radiotherapy show marked regression in size of lesion, perilesional odema and mass effect. The positive response is indicating that we are on the right tract and supporting the diagnosis of Lymphoma. 

Non Hogkin's Lymphoma

A 40 yo male admitted for headache.
Neurological examination normal.
On admission CT shows a hyper dense focal lesion in the region of right basal ganglia with moderate uniform enhancement, marked perilesional vasogenic odema.
Imaging wise possible DDs suggested were Lymphoma and Toxoplasmosis. 

Immune status : Tridot Non reactive.
Csf : Slightly raised protein. Otherwise normal.
CT Chest showed multiple bilateral discrete soft tissue density parenchymal nodules.
CT Abdomen normal.
Neck nodes biopsy and histopathology revealed Non Hogkin's Lymphoma.









The follow up CT after course of radiotherapy shows significant regression in size of lesion, perilesional odema and mass effect support diagnosis of Systemic Non Hogkin's Lymphoma (NHL) with CNS involvement.