Misc

Question 1

Diffusion restricton DDx (5)

Answer 1

Supratentorial mass with restriction
- Abscess
- Lymphoma
- Rarely could be GBM or Medulloblastoma
CP angle
- Epidermoid
Temporal horns
- Herpes encephalitis

Question 2

Midline crossing DDx (3)

Answer 2

GBM or Lymphoma.
Alternatively, radiation necrosis, big MS plaque or meningioma of the falx simulating a midline cross

Question 3

Calcification DDx (2)

Answer 3

If in the brain, probably Oligodendroglioma.
Astrocytomas only calcify 20% of the time, but are much more common.

Question 4

T1 bright DDx (5)

Answer 4

Tumour that has bled
- Pituitary apoplexy or haemorrhagic mets
Haemorrhagic mets
- Melanoma, Renal, Carcinoid, Choriocarcinoma, Thyroid.
Tumours with fat will also be T1 bright.
- Lipoma, Dermoid.
Melanin is also T1 bright (melanoma).
Cholesterol in a colloid cyst.

Question 5

Nevoid basal cell syndrome (Gorlin)

Answer 5

Medulloblastoma

Question 6

Turcot syndrome (2)

Answer 6

Medulloblastoma,
GBM

Question 7

Cowdens

Answer 7

Lhermitte-Dulcos (dysplastic cerebellar gangliocytoma)

Question 8

Tumours everywhere (5)

Answer 8

Likely dealing with NF2.
Not associated with neurofibromas!
MSME:
Multiple Schwannomas,
Meningiomas,
Ependymomas

Question 9

Lhermitte-Dulcos (dysplastic cerebellar gangliocytoma) (5)

Answer 9

Very uncommon, but when you see it, think
- Cowden’s syndrome
- Associated with breast cancer, needs mammogram
Classic tiger stripe mass, typically contained on one cerebellar hemisphere (occasionally crosses the vermis).
Not cancer, but a hamartoma.