Case referred from HRPZII
Case of cerebral lesion with underlying Intravetrious lymphoma.
Ahmad Najib bin Hashim 
770225115505

yellow zone hrpz2

Name :ahmad Najib bin hashim (770225115505)

Underlying primary intravitreous lymphoma
-completed de angelis chemotherapy for 10/52
-completed radiotherapy at husm #18

Referred case from hospital besut for abnormal behaviour to rule out brain metastases

Presented with abnormal behaviour x3/7
-lethargy x3/52
-unwell x3/52
-headache x3/52
-loose stool x2/7
-feverish x1/7

No urti/uti sx
No sob
No chest pain
No abdominal pain
No covid contact

At ed
E3v4m6- confused, tachypneic with RR 26,spo2 98% under room air
BP 141/85
Hr 105
T 37.3

Lungs clear
Cvs s1s2

Twc 16/hb 15/plt 318
Creat 110/urea 7.8/na 133/k 3. 7

Cxr - clear


CT brain : cerebral oedema with midline shift (0.5cm)

Imp: altered behaviour 2 to multifactorial :
-septic encephalopathy 
-tro brain mets
-AKI

Started on Dexa and Phenytoin
For MRI Brain
Rfer back to Haemato for risk prognostification


Plan - For reprognostication by Haemato.
For