Crossed cerebellar diaschisis due to cerebral diffuse large B cell lymphoma on 18F-FDG PET/CT

Excerpt

A 55-year-old male with a history of diffuse large B cell lymphoma (DLBCL) presented with right-arm weakness, expressive dysphasia, and left Horner’s syndrome. CT brain demonstrated multiple left supratentorial masses, and involvement including the left midbrain (Fig. 1a). Disease recurrence was diagnosed following stereotactic biopsy. 18F-FDG PET/CT of the whole body 2 weeks post-biopsy for complete staging demonstrated the masses to be markedly FDG-avid, with the most FDG-avid focus within the left midbrain (Fig. 1b, SUV_max = 19.4). No active extracranial disease was demonstrated. There was a mild generalised reduction in metabolism throughout the left cerebral grey matter compared to the right, with reduced FDG uptake throughout the contralateral cerebellar hemisphere (Fig. 1c, d, coronal images) in keeping with crossed cerebellar diaschisis (CCD).

…