Malignant neoplasm of lower lobe, right bronchus or lung [C34.31], Reason for Study: ^Reason: newly diagnosed squamous cell cancer of the lung , eval for mets History: none No evidence of acute ischemic or hemorrhagic lesion on scan.There is well enhancing, slightly expansile T1 low, T2 high skull lesion (5.9 mm x 11.3 mm x 11.8 mm) at the left parietal bone. This is a new lesion comparing to prior scan.There is no associated soft tissue mass lesion. There is no definitive evidence of inner or outer table disruption. Considering the patient's clinical history and interval development, differential diagnosis include metastatic lesion. Other differential diagnosis include benign lesions such as epidermoid cyst.Underlying brain shows patchy FLAIR/T2 high signal intensity lesions on bilateral periventricular white matter and centrum semiovale indicating non specific small vessel ischemic disease, progressed since prior scan. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Retention cysts were seen within left maxillary sinus and bilateral posterior ethmoid sinuses.
1. Left parietal skull lesion with enhancement. Differential diagnosis include metastatic lesion and epidermoid cyst. Head CT scan may be useful for additional imaging evaluation.2. Non specific small vessel ischemic disease.3. No evidence of acute ischemic or hemorrhagic lesion.