PMC7199007_01
CT head without contrast done at admission. Red circle highlights 3.2cm hypodense lesion. L for left, P for posterior. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Computerized tomography (CT) of the head revealed a 3.2 cm hypodense lesion in the left frontal lobe with surrounding calcification versus hemorrhage (Fig. 1).
A-D: MRI brain showed: A. A moderate size acute infarction in the right frontoparietal lobe (red circle) and left frontoparietal deep white matter suggestive of embolic etiology (blue circle).. B. Small amount of internal petechial hemorrhage (white circles).. C. Numerous scattered infarctions of the right cerebral (red circle) and cerebellar hemisphere.. D. Rim-enhancing lesion (red square) in the left frontal lobe with surrounding edema suggestive of metastatic disease. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Magnetic resonance imaging (MRI) brain showed a moderate size acute infarction in the right frontoparietal lobe with small amount of internal petechial hemorrhage, numerous scattered infarctions of the right cerebral hemisphere, cerebellar hemisphere, and left frontoparietal deep white matter suggestive of embolic etiology, and a rim-enhancing lesion in the left frontal lobe with surrounding edema suggestive of metastatic disease (Fig. 2A-D).
A-B:. A. 8.9 cm necrotic right infrahillar lower lung mass (red circle). P for posterior.. B. Coronal view of mass (blue circle) with associated pulmonary embolism in distal right main pulmonary artery with extension into the right upper and lower lobe segmental artery branches. I for inferior. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Hematology/oncology and pulmonology consultation resulted in CT chest and abdomen, showing large 8.9cm necrotic right infrahillar and lower lung mass, pulmonary embolism in distal right main pulmonary artery with extension into the right upper and lower lobe segmental artery branches, and scattered hypodensities measuring 6 mm throughout the right hepatic lobe likely representing metastasis in the setting of malignancy (Fig. 3A-B).