case_images: PMC10599841_01
case_images: MRI and FDG-PET/CT at initial presentation and following treatment. At presentation (a) demonstrates a region of T2 FLAIR hyperintensity in the right middle cerebellar peduncle with an avidly enhancing 13 mm nodule (red arrow) on postcontrast T1. There was evidence of a small focus of intralesional haemorrhage on susceptibility weighted imaging (pink arrow). The lesion demonstrates moderately avid tracer uptake SUVMax 7.6 (blue ring). Following biopsy, chemotherapy, and ASCT (b), there was complete resolution of the T2 FLAIR signal (yellow ring); no residual enhancement on postcontrast T1 and haemosiderin staining (pink arrow). No residual FDG tracer uptake within this focus on FDG-PET.
case_images: CRIHEM2023-6650410.001.jpg
case_images: PMC10599841_01_CRIHEM2023-6650410.001.jpg
case_images: fig1
case_images: Magnetic resonance imaging (MRI) of the brain demonstrated an enhancing lesion centred on the brachium pontis (13 x 10 x 10 mm) (Figure 1). CT/fluorodeoxyglucose (FDG) positron emission tomography (PET), the lung lesions were not FDG-avid; however, the brainstem lesion was mildly FDG-avid (Figure 1). Cerebrospinal fluid (CSF) analysis was unremarkable including tests for cytology, microbiology, flow cytometry, and oligoclonal bands. MRI of the brain was performed post-transplant demonstrating resolution of all enhancing CNS lesions consistent with a complete response (CR) (Figure 1).