Malignant neoplasm of bronchus and lung, unspecified site. Secondary malignant neoplasm of brain and spinal cordClinical question: hx of lung CA, eval mets, please compare to previous and measure The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. A submillimeter subtle focus of apparent enhancement in the left medial temporal lobe (image 29 series 1101) is felt to represent artifact. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is redemonstration of confluent T2 and FLAIR hyperintense lesions along the periventricular and external capsules which is unchanged since the prior exam.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 convincing evidence for recurrent metastasis. A submillimeter focus of apparent enhancement in the left temporal lobe is felt to represent artifact. Continued close interval follow-up is suggested.2.There is periventricular and external capsule signal change which is likely treatment related.