UMEM Educational Pearls

Category: Visual Diagnosis

Title: What's the Diagnosis?

Posted: 4/29/2012 by Haney Mallemat, MD (Emailed: 4/30/2012) (Updated: 4/30/2012)
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68 yo man presents with new-onset seizures; his CT is shown below. What is your differential diagnosis?


Cerebral Ring-Enhancing Lesions


  • Primary brain tumor
  • Primary CNS lymphoma
  • Metastatic disease


  • Pyogenic abscess
  • Tuberculoma
  • Syphilis
  • Neurocysticercosis  
  • Toxoplasmosis
  • Nocardiosis
  • Cryptococcosis
  • Aspergillosis


  • Multiple sclerosis (lesions within the white matter)
  • Sacroidosis
  • Vasculitis
  • Aneurysm
  • Resolving hematoma
  • Cerebral infarct
  • Postoperative change

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Garg, R., Sinha, M. Multiple ring-enhancing lesions of the brain. J Postgrad Med. 2010 Oct-Dec; 56(4):307-16

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