CLL and MDS admitted for worsening anemia and found with disease evolution to AML. Co-morbid conditions include CHF, SLE and Renal Transplantation. Course complicated by extremely poor functional status and delirium. There are subcentimeter foci of high T2 signal with mildly restricted diffusion, but no enhancement, within the left frontal lobe, in a linear trajectory. There are otherwise a few scattered nonspecific foci of high T2 signal within the cerebral white matter bilaterally. There is a left paraclinoid dural-based enhancing mass that measures up to 17 mm. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is moderate mucosal thickening in the right maxillary sinus.
1. Subcentimeter foci of high T2 signal with mildly restricted diffusion, but no enhancement, in a linear trajectory within the left frontal lobe, may represent recent infarcts rather than a neoplastic process.2. A left paraclinoid dural-based enhancing mass that measures up to 17 mm likely represents a meningioma.