Answer of January 2025

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Clinical History:

A 81-year-old lady with history of autoimmune disease on long term immunosuppressant presented with insidious onset of decreased general condition for few weeks. Physical examination was unremarkable. She was afebrile. Plain computed tomography (CT) brain showed a space occupying lesion at right basal ganglia with mass effect. Magnetic resonance imaging (MRI) brain with contrast was performed.

Axial plain CT brain

Axial MRI brain T2 weighted sequence

Axial MRI brain T1 weighted sequence

Axial MRI brain Fluid attenuated inversion recovery (FLAIR) sequence with contrast

Axial MRI brain gradient echo sequence

Axial MRI brain diffusion weighted imaging (DWI) sequence, B-value =1000

Axial MRI brain apparent diffusion coefficient (ADC) map

Axial MRI brain T1 weighted sequence with contrast

Axial MRI brain T2 weighted sequence

Axial MRI brain T1 weighted sequence

Axial MRI brain Fluid attenuated inversion recovery (FLAIR) sequence with contrast

Axial MRI brain gradient echo sequence

Axial MRI brain diffusion weighted imaging (DWI) sequence, B-value =1000

Axial MRI brain apparent diffusion coefficient (ADC) map

Axial MRI brain T1 weighted sequence with contrast

Axial MRI brain T1 weighted sequence with contrast