Hindawi Publishing Corporation Case Reports in Radiology Volume 2013, Article ID 916348, 5 pages http://dx.doi.org/10.1155/2013/916348 Case Report A Case of Primary T-Cell Central Nervous System Lymphoma: MR Imaging and MR Spectroscopy Assessment G. Manenti, F. Di Giuliano, A. Bindi, V. Liberto, V. Funel, F. G. Garaci, R. Floris, and G. Simonetti Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiation herapy, Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy Correspondence should be addressed to F. Di Giuliano; francescadigiuliano@msn.com Received 19 March 2013; Accepted 7 May 2013 Academic Editors: R. Dammers, E. Kapsalaki, L. Lampmann, and D. P. Link Copyright © 2013 G. Manenti et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Primary central nervous system lymphomas (PCNSLs) are mainly B-cells lymphomas. A risk factor for the development of PCNSL is immunodeiciency, which includes congenital disorders, iatrogenic immunosuppression, and HIV. he clinical course is rapidly fatal; these patients usually present signs of increased intracranial pressure, nausea, papilledema, vomiting, and neurological and neuropsychiatric symptoms. PCNSL may have a characteristic appearance on CT and MR imaging. DWI sequences and MR spectroscopy may help to diferentiate CNS lymphomas from other brain lesions. In this paper, we report a case of a 23-year- old man with T-primary central nervous system lymphoma presenting with a mass in the right frontotemporal lobe. We describe clinical, CT, and MRI indings. Diagnosis was conirmed by stereotactic biopsy of the lesion. 1. Introduction PCNSL causes approximately 3%-4% of all primary brain tumors. PCNSL is deined as lymphoma in the central nervous System (CNS) without primary tumor elsewhere. PCNSL is mainly difuse large B-cell lymphoma; less common PCNSL histological types are Burkitt’s lymphoma and T-cell lymphoma. Our case is about a 23-year old man with T-cell central nervous system lymphoma (T-PCNSL). 2. Clinical History A 23-year-old man was referred to our emergency room because of nausea, vomiting with associated acute con- fusional state. Neurological examination revealed slow response, postural instability without rigidity or tremor in any of the four extremities, and normal sensation. No remarkable abnormality was observed at the physical examination. Laboratory tests were within normal limits, in exception for LDH 61,1 mU/mL (5–36 mU/mL normal range). Past medical history was negative for considerable pathol- ogies. HIV status of the patient was positive. Computed tomography (CT) of the brain revealed a 6×5 cm mild hyperdense mass in the right frontotemporal region with associated perilesional oedema. Mild mass efect on the homolateral ventricle was observed with 1 cm midline shit. CT also revealed the presence of another similar lesion measuring 3,5 cm localized in the right cerebellar lobe (Figure 1). In the next, CT scan was integrated with brain MRI and single-voxel (1)H MR spectroscopy. Difusion weighted imaging (DWI) showed hyperintense lesions at the right fronto-temporal area and at the right cere- bellar lobe, respectively (Figure 2); apparent difusion coef- icient (ADC) map conirmed the presence of hypointense lesions. Masses appeared mildly hyperintense also in T2-weighted MR images with peri-lesional oedema (Figure 3). T1-weight- ed images showed the presence of multiple millimetrical cystic formations in the center of the huge sovra-tentorial lesion.