case_images: PMC3740612_01
case_images: MRI demonstrating multiple hemorrhagic foci in bilateral cerebral hemispheres.
case_images: SNI-4-99-g001.jpg
case_images: PMC3740612_01_SNI-4-99-g001.jpg
case_images: F1
case_images: A MRI [Figure 1] was repeated, which showed multiple hemorrhagic foci in bilateral cerebral hemispheres, with perilesional edema and mild mass effect.
case_images: CT scan demonstrating increase in multiple hypodensities in bilateral cerebral hemispheres.
case_images: SNI-4-99-g002.jpg
case_images: PMC3740612_01_SNI-4-99-g002.jpg
case_images: F2
case_images: An urgent CT scan [Figure 2] revealed an increase in size of multiple scattered hypodense lesions involving the deep white and subcortical matter in both cerebral hemispheres compared with the recent MRI.
case_images: A leptomeningeal vessel showing luminal occlusion by large pleomorphic lymphoma cells (H&E x 200); CD20 stains the intraluminal tumour cells (CD20 x 200); The proliferative marker Ki-67 labels majority of the intraluminal tumor cells (Ki67 x 200)
case_images: SNI-4-99-g003.jpg
case_images: PMC3740612_01_SNI-4-99-g003.jpg
case_images: F3
case_images: The blood vessels of the leptomeninges, cerebral cortex and white matter demonstrated multifocal occlusion by large lymphoid cells with pleomorphic nuclei, prominent nucleoli and mitotic activity [Figure 3a] and [Figure 4]. The intraluminal lymphoid cells showed strong expression of the B lymphocyte marker C20 by immunoperoxidase staining [Figure 3b]. Ki67 labeled the majority of the atypical lymphoid cells [Figure 3c].
case_images: White matter with vessels showing luminal occlusion by lymphoma cells (H&E x 400)
case_images: SNI-4-99-g004.jpg
case_images: PMC3740612_01_SNI-4-99-g004.jpg
case_images: F4
case_images: The blood vessels of the leptomeninges, cerebral cortex and white matter demonstrated multifocal occlusion by large lymphoid cells with pleomorphic nuclei, prominent nucleoli and mitotic activity [Figure 3a] and [Figure 4].