Other pulmonary embolism without acute cor pulmonale [I26.99], Reason for Study: ^Reason: Assess brain lesion History: N/A There is 16.3mm (AP) x 15.5mm (CC) and 13.5mm (RL) sized relatively well circumscribed intra axial mainly cystic lesion at the right frontal operculum (right subcentral lobule) with surrounding edema and irregular rim enhancement. There are also a couple of daughter nodules with peripheral enhancement see on post enhanced images. The content of the lesion does not show restricted diffusion. There is no other abnormal enhancing lesion on this scan. Comparing to prior scan obtained outside institution (Sep 15 2015), although overall size of the lesion appears to be decreased and intra lesional fluid fluid level has been not as conspicuous but the enhancing rim has been thickened, peripheral daughter nodules show interval increase in size and the extent of surrounding edema has been increased comparing to the size of the lesion. There is evidence of right fronto-temporal craniotomy.The ventricles, sulci and cisterns are symmetric and unremarkable. Multifocal patchy high signal intensities on bilateral periventricular white matter, bilateral external capsules on FLAIR/T2 images appear to be stable.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.Minimal mucosal thickenings on ethmoid sinuses.
1. Interval progression of the thickness of enhancing rim, increased size of enhancing peripheral daughter nodules and the extent of surrounding edema of the right frontal opercular cystic lesion as described above since prior scan (Sep 15 2015).2. No change of high signal intensity lesions on bilateral periventricular white matter and external capsule.3. No acute ischemic or hemorrhagic lesion. No new abnormal enhancing lesion.