Primary central nervous system lymphoma (PCNSL) may affect the basal nuclei of the brain. The most common type is diffuse large B-cell lymphoma. This is a case report of an adolescent with rare bilateral lymphoma in the basal ganglia. A male patient aged 16 years had a clinical picture of rapid progression to motor aphasia, dysphagia, and right hemiplegia. Magnetic resonance imaging (MRI) of the skull, along with spectroscopy, indicated lymphoproliferative or neoplastic disease. A biopsy confirmed diffuse large B-cell lymphoma. However, the patient died before starting the definitive treatment. PCNSL is infrequent in the pediatric population, but it has a better prognosis in this age group, especially when diagnosed early. It affects immunodeficient patients more often. In addition to MRI, spectroscopy and positron-emission tomography help clarify the diagnosis. Biopsy is a gold standard for diagnosis, leading to the appropriate initiation of chemotherapy and radiotherapy treatment. PCNSL is rare in young patients. With an early diagnosis, better therapeutic planning is possible. Unfortunately, in the present case, the diagnosis was late, and the patient had an unfavorable outcome.
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