3 Multiple Enhancing Cerebral and Cerebellar Nodules

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig SK 3-1 Metastatic carcinoma. Multiple enhancing masses of various shapes and sizes representing hematogenous metastases from carcinoma of the breast.

Fig SK 3-2 Metastatic carcinoma. Multiple enhancing masses representing hematogenous metastases from carcinoma of the lung.

• Fig SK 3-3 Primary lymphoma. (A) Homogeneous enhancement of multiple periventricular nodules (arrows). (B) Another section shows additional enhancing lymphomatous nodules in the basal ganglia (large arrows) and posterior fossa (small arrows). Note the cystic cavum septum pellucidi (open arrow).1

• Fig SK 3-4 Multiple sclerosis simulating metastases. Nodular enhancement in periventricular and subcortical white matter resulting from demyelination.1

Fig SK 3-5 Multiple sclerosis. Single large ring-enhancing lesion.

• Fig SK 3-6 Cysticercosis. Multiple, enhancing nodules or rings, some of which contain focal calcification representing the scolices of erupted larvae. Note the zones of surrounding edema.1

• Fig SK 3-7 Cysticercosis. Multiple enhancing nodules.

Fig SK 3-8 Subacute, multifocal infarction. Multiple enhancing nodules producing a pattern mimicking metastases.

• Fig SK 3-9 Sarcoidosis. (A) Coronal postcontrast T1-weighted image shows abnormal pial enhancement. There is also abnormal enhancement along the perivascular spaces for the lenticulostriate arteries and in the pituitary stalk. (B) Midsagittal postcontrast T1-weighted image (different patient) shows sarcoid deposits (s) in the posterior interhemispheric fissure and in the sella. (C) Axial postcontrast T1-weighted image of a different patient shows dural and mass-like (s) sarcoid deposits simulating meningiomas (avascular at angiography).7