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Ring-enhancing lesion in suspected CNS lymphoma (MRI)

Axial brain MRI (T1 with contrast) shows a 7 mm ring-enhancing periventricular lesion in the right frontal lobe abutting the frontal horn of the right lateral ventricle and corpus callosum in a HIV-positive patient. Differential diagnosis includes opportunistic infection, such as toxoplasmosis, mycobacterial, fungal infections, or CNS lymphoma. Later on patient was found to have elevated EBV PCR with negative toxoplasmosis serology making CNS lymphoma a suspected etiology. A cavum septum pellucidum is also present in this MRI. (Contributed by Dr. Jan Bittar.)

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