Sagittal T1-weighted image (A) shows no definite abnormality. Axial T2-weighted FLAIR image (B) demonstrates multiple punctate hyperintense foci involving the deep and periventricular white matter of the bilateral cerebral hemispheres with corresponding restricted diffusion on the axial diffusion weighted trace (C) image. Axial T1-weighted post contrast image (D) reveals numerous punctate foci of enhancement corresponding to the deep and periventricular white matter lesions (white arrows). In this patient, the differential diagnosis included intravascular lymphoma, granulomatous disease, neurosarcoidosis, and vasculitis.
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