CC BY 4.0 · World J Nucl Med 2023; 22(01): 029-032
DOI: 10.1055/s-0042-1757253
Case Report

Crossed Cerebellar Diaschisis in Thalamic Lymphoma on 18F-FDG PET/CT

Amit Bhoil
1   Department of Nuclear Medicine, The Royal Liverpool University Hospital NHS Trust, Liverpool, United Kingdom
,
Igor RacuAmoasii
2   Haemato-oncology Diagnostic Service, Liverpool Clinical Laboratories, Liverpool, United Kingdom
,
Sobhan Vinjamuri
1   Department of Nuclear Medicine, The Royal Liverpool University Hospital NHS Trust, Liverpool, United Kingdom
› Institutsangaben
Funding None.

Abstract

Primary central nervous system lymphomas (PCNSLs) are extranodal variant forms of non-Hodgkin lymphoma arising within the brain parenchyma, leptomeninges, or spinal cord. PCNSL can present with varied neurological symptoms and imaging findings, making diagnosis without biopsy difficult. PCNSLs are highly aggressive, causing rapid deterioration, but are responsive to chemotherapy and radiotherapy making early diagnosis important.

Crossed cerebellar diaschisis (CCD) is mostly seen with cerebral cortex vascular insults and is rarely reported with thalamic lesions and even rarer with thalamic lymphoma. However, CCD has also been described in other brain tumors (including primary glioma), chronic subdural hematoma, congenital insults, intracranial infections, and various dementia subtypes.

We present a rare case of thalamic lymphoma evaluated with positron emission tomography/computed tomography that showed hypermetabolism of thalamus and associated hypometabolism in ipsilateral cerebral cortex and contralateral cerebellum representing CCD.

Note

The manuscript has been read and approved by the author that the requirements for authorship as stated earlier in this document have been met, and that author believes that the manuscript represents honest work, if that information is not provided in another form




Publikationsverlauf

Artikel online veröffentlicht:
09. September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Fine HA, Mayer RJ. Primary central nervous system lymphoma. Ann Intern Med 1993; 119 (11) 1093-1104
  • 2 Traweek ST. Nervous system involvement by lymphoma, leukemia and other hematopoietic cell proliferations. In: Bigner DD, McLendon RE, Bruner JM. eds. Russell & Rubinstein's Pathology of Tumors of the Nervous System. 6th edition. London: Arnold Press; 1998: 195-237
  • 3 Gerstner ER, Batchelor TT. Primary central nervous system lymphoma. Arch Neurol 2010; 67 (03) 291-297
  • 4 Eichler AF, Batchelor TT. Primary central nervous system lymphoma: presentation, diagnosis and staging. Neurosurg Focus 2006; 21 (05) E15
  • 5 Finelli PF, DiMario Jr FJ. Diagnostic approach in patients with symmetric imaging lesions of the deep gray nuclei. Neurologist 2003; 9 (05) 250-261
  • 6 Lim JS, Ryu YH, Kim BM, Lee JD. Crossed cerebellar diaschisis due to intracranial hematoma in basal ganglia or thalamus. J Nucl Med 1998; 39 (12) 2044-2047
  • 7 Sobesky J, Thiel A, Ghaemi M. et al. Crossed cerebellar diaschisis in acute human stroke: a PET study of serial changes and response to supratentorial reperfusion. J Cereb Blood Flow Metab 2005; 25 (12) 1685-1691
  • 8 Förster A, Kerl HU, Goerlitz J, Wenz H, Groden C. Crossed cerebellar diaschisis in acute isolated thalamic infarction detected by dynamic susceptibility contrast perfusion MRI. PLoS One 2014; 9 (02) e88044
  • 9 Barbara FW, Eduado EB, Jasper RD, Thomas JR, Burton AS. Medical Neurosciences, Motor System. 3rd edition. Boston: Little Brown & Co.; 1994: 193-195
  • 10 Snider RS, Maiti A, Snider SR. Cerebellar pathways to ventral midbrain and nigra. Exp Neurol 1976; 53 (03) 714-728
  • 11 Hoover JE, Strick PL. Multiple output channels in the basal ganglia. Science 1993; 259 (5096): 819-821
  • 12 Sebök M, van Niftrik CHB, Halter M. et al. Crossed cerebellar diaschisis in patients with diffuse glioma is associated with impaired supratentorial cerebrovascular reactivity and worse clinical outcome. Cerebellum 2020; 19 (06) 824-832
  • 13 Demir Y, Sürücü E, Çilingir V, Bulut MD, Tombul T. Dyke-Davidoff-Masson syndrome with cerebral hypometabolism and unique crossed cerebellar diaschisis in 18F-FDG PET/CT. Clin Nucl Med 2015; 40 (09) 757-758
  • 14 Agarwal KK, Tripathi M, Karunanithi S, Das CJ, Suri V, Nalwa A. Crossed cerebellar diaschisis in cerebral toxoplasmosis demonstrated on 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2014; 33 (06) 397-398
  • 15 Franceschi AM, Clifton MA, Naser-Tavakolian K. et al. FDG PET/MRI for visual detection of crossed cerebellar diaschisis in patients with dementia. AJR Am J Roentgenol 2021; 216 (01) 165-171
  • 16 Chiavazza C, Pellerino A, Ferrio F, Cistaro A, Soffietti R, Rudà R. Primary CNS lymphomas: challenges in diagnosis and monitoring. BioMed Res Int 2018; 2018: 3606970
  • 17 Abrey LE, Batchelor TT, Ferreri AJM. et al; International Primary CNS Lymphoma Collaborative Group. Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J Clin Oncol 2005; 23 (22) 5034-5043