Malignant poorly differentiated neuroendocrine carcinoma, any siteClinical question: 60 y/o pt with newly diagnose lung neuroendocrine CA; please eval for metsSigns and Symptoms: see aboveComments: Pt has difficulty breathing when laying flat and will need breathing treatment prior to going down. Please page 4937 with MRI time to coordinate. | The CSF spaces are appropriate for the patient's stated age with no midline shift. Exam is degraded due to patient motionThere is a small lesion which is bright on diffusion-weighted imaging and dark on the ADC map present in the right cerebellar tonsilTo the extent of visualization possible given only the limited imaging available 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.To the extent of visualization possible given only the limited imaging available 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.Examination is limited due to patient motion and the patient inability to continue with the exam. If clinically appropriate when the patient is able to and perhaps with the added benefit of sedation additional imaging may be possible.2.Along the right cerebellar tonsil there is a small lesion which is not well-defined on the available pulse sequences. Additional imaging may be of benefit to further evaluate this