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All right, my faithful watchers and listeners,

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this is our quiz case.

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So here we have a patient who has a known lymphoma.

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We know that lymphoma is one of the diagnoses that

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can lead to intradural intramedullary lesions.

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intradural extramedullary lesions,

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as well as extradural lesions.

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So you can have it in the spinal cord,

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you can have it seeding into the subarachnoid space

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in the intradural extramedullary compartment,

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and you may have it involving the bones or the soft

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tissues outside the dura as extradural disease.

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So this is a T1-weighted scan to the left

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and a T2-weighted scan to the right.

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Quiz time. Where's the lesion

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as far as the space? In this case,

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what we see is the mass here.

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But as we look at the CSF space associated with it,

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we see that it narrows rather than

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widens at the junction with the mass.

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Here, the CSF space is narrowing rather than widening.

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So this is lymphoma,

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but this is lymphoma in the extradural compartment,

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not the intradural extramedullary compartment.

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So, this is how we would analyze this case.

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Lymphomas can be in any of the

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different spaces,

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but by virtue of the narrowing at the junction

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with the tumor rather than widening.

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This is an extradural lymphoma.

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You might want to look at the signal

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intensity of the spinal cord,

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because although this is compressing

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the spinal cord,

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you don't see bright signal intensity

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in the spinal cord.

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This is a patient who we would not expect to

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have a myelopathy associated with the mass.

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And lymphoma is a type of tumor that will readily

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respond to both radiation and chemotherapy

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and may not require surgery.