Diagnosis: Malignant neoplasm of bronchus and lung, unspecified siteClinical question: initial lung cancer stagingSigns and Symptoms: initial lung cancer staging The CSF spaces are appropriate for the patient's stated age with no midline shift. There are is a FLAIR and T2 and diffusion-weighted imaging signal hyperintense focus in the right choroid plexus and the smaller one in the left choroid plexus. Most likely these represent xanthogranulomas.There is a 34 x 23 mm axial dimension cystic lesion in the anterior aspect of the left middle cranial fossa associated with remodeling of the adjacent bone. It follows spinal fluid on all pulse sequences.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is no evidence for brain metastasis appreciated. 2.Arachnoid cyst in the left middle cranial fossa.3.Periventricular and subcortical white matter signal changes of a mild degree are present which are nonspecific. They could be vascular related, related to demyelination, trauma, vasculitis, sarcoid. They are nonspecific. 4.Choroid plexus lesions most likely represent xanthogranulomas.