Female, 79 years old, history of lung adenocarcinoma with decreased appetite and dysphagia, assess for metastases. No evidence of parenchymal edema or mass effect is seen. Moderately extensive scattered foci of FLAIR hyperintensity are demonstrated in the subcortical and periventricular tissues. On postcontrast images, no pathologic parenchymal or leptomeningeal enhancement is seen. Faint gyriform susceptibility effect is noted scattered along the cerebral hemispheres, particularly the bilateral parietal and occipital lobes. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size.The pituitary gland is enlarged and somewhat heterogeneously enhancing measuring up to 11 mm in craniocaudal dimension. Bone marrow signal characteristics are within normal limits.
1.No definite evidence of intracranial metastases or any other specific findings which would account for the patient's symptoms. Scattered small lesions likely reflect chronic microvascular ischemia. Faint susceptibility effect is of uncertain etiology and may represent the sequelae of a prior hemorrhagic event.2.The pituitary gland is enlarged for age and somewhat heterogeneously enhancing. Metastases to the pituitary gland are quite rare and as such this is favored to represent an unrelated and incidental pituitary lesion such as an adenoma or a cyst. Dedicated pituitary imaging can be considered for further evaluation as clinically warranted.