Diagnosis: Malignant neoplasm of unspecified part of unspecified bronchus or lungClinical question: eval for pre-op brain biopsySigns and Symptoms: brain lesion There is T2 hyperintensity associated with sulcal enhancement and some contrast enhancement along the white matter of the right fusiform inferior temporal gyri. It is associated with mass effect and some compression of the trigone of the right lateral ventricle which was also present on the MRI from 12/2/2015.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.
There is a lesion involving the right fusiform gyrus and inferior temporal gyrus which was defined on the recent MRI of the brain. Differential considerations could include the an infiltrative lesion such as lymphoma, leptomeningeal disease (including carcinomatosis) or granulomatous disease.