 There is a well-defined, spherical, 5 mm diameter periapical lesion with mildly increased T2 signal in the left maxilla associated with the root of left second maxillary molar tooth. There is mild mucosal thickening along the floor of the left maxillary sinus. The other paranasal sinuses are unremarkable. The bilateral mastoids air cells and the middle ear cavity are grossly unremarkable. The orbits appear to be intact. The previously demonstrated left frontal convexity extra-axial subcentimeter lesion is not as apparent on this exam due to technique. There are foci of T2 hyperintensity in the left frontal lobe deep white matter.
1. A subcentimeter periapical lesion associated with tooth #14 likely represents a periapical abscess, perhaps with mild reactive mucosal inflammation in the inferior left maxillary sinus.2. The previously demonstrated left frontal convexity extra-axial subcentimeter meningioma is not as apparent on this exam due to technique.3. Left frontal lobe white matter lesions that may represent chronic manifestations of lupus cerebritis.