Imaging of hemorrhagic primary central nervous system lymphoma: A case report.

BACKGROUND: A primary central nervous system lymphoma (PCNSL) presenting with massive hemorrhage is a rare occurrence that is difficult to distinguish from a high-grade glioblastoma. Comprehensive descriptions of the imaging characteristics of such tumors have not yet been reported. Herein, we reported a case of a PCNSL with massive hemorrhage by presenting the imaging features of computed tomography (CT) imaging and structural and perfusion magnetic resonance imaging (MRI). CASE SUMMARY: A 48-year-old man presented with headache lasting for 10 d. CT of the brain showed a round, heterogeneous, high-density lesion with surrounding edema in the right temporal lobe. For further diagnosis, a series of MRI examinations of the brain were subsequently performed, and a hemorrhagic lesion with ring-like enhancement was determined. The whole lesion was relatively hypoperfused on arterial spin labeling images. Surgical resection of the lesion and histopathological examination confirmed that the lesion was a diffuse large B-cell lymphoma with massive hemorrhage. CONCLUSION: PCNSLs with hemorrhage occur very rarely, and structural and perfusion MRI examinations are requested exceedingly rarely. This case provided insight into some characteristics of a hemorrhagic lymphoma on CT and MRI examinations. Perfusion MRI examination may be useful for the differential diagnosis of PCNSLs and other brain tumors.

Imaging of mixed epithelial and stromal tumor of the kidney: A case report and review of the literature.

BACKGROUND: Mixed epithelial and stromal tumors of the kidney (MESTKs) are a rare entity (about a hundred cases reported). They occur almost exclusively in postmenopausal women, with only seven cases reported in men. As this entity is very rare, little is known on its imaging features, especially magnetic resonance imaging (MRI) findings. In women, at MRI, the cystic component shows T1 hypointensity and T2 hyperintensity, while the solid component shows T1 hyperintensity and T2 hypointensity. CASE SUMMARY: We report the computed tomography (CT) and MRI findings of MESTK in a 19-year-old male adolescent. To our knowledge, this case report is the first report of MRI findings of MESTK in male adolescents. The patient was admitted to Subei People's Hospital (Jiangsu Province, China) in July 2017 after a renal mass on the left side was detected by ultrasound during a clinical examination. Blood tests were all normal. Non-enhanced CT showed a round, well-circumscribed complex mass, approximately 45 mm × 40 mm in size. MRI revealed a clear well-circumscribed mass with a mixed arrangement of solid and cystic components. On T2 weighted images, some hypointensities were found in the solid areas. After contrast enhancement, moderate or mild enhancement was found in the solid component, which increased with time. A radical left nephrectomy was performed. The pathology analysis revealed a mixed epithelial and stromal tumor. The patient had no imaging findings of recurrence or metastasis at 12 months following surgery. CONCLUSION: The possibility of MESTK should be considered in male adolescents. MRI can provide useful information for the preoperative diagnosis.