PMC5824641_01
Initial and follow-up magnetic resonance imaging brain scans showing multiple cortically-based signal abnormalities. Images A-C are axial fluid-attenuated inversion recovery images showing multifocal elevated cortical T2/FLAIR signal intensity with associated swelling with involvement of the adjacent subcortical white matter from patient's initial presentation. There was no contrast enhancement, and there was no definite involvement of the deep gray structures, brainstem, or cerebellum. Images D-F are follow up images approximately two weeks later that reveal overall improvement, for instance, previously seen abnormality along the medial left frontal lobe, and in the posterior right insular lesion improved
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F1
Computed tomography head showed multiple cortical hypodensities, prompting an magnetic resonance imaging (MRI) brain, which revealed multiple foci of cortical hyperintensity involving the medial left frontal cortex, the right dorsal aspect of the insula and adjacent right temporal cortex as well as the posterior left temporal cortical medullary junction and the medial posterior left temporal cortex and lateral cortex [Figure 1]. Repeat imaging 2 weeks after initial presentation showed improvement in the cortical lesions, specifically, decrease in the abnormal fluid-attenuated inversion recovery (FLAIR) hyperintensities [Figure 1].
Computed tomography chest showing large right mediastinal mass. Contrast-enhanced computed tomography images (A: axial; B: coronal), showing a large multilobulated right anterior mediastinal mass measuring 6.0 cm x 4.7 cm in transverse dimension by approximately 13 cm in craniocaudal dimension. There was found to be mass effect with mild compression of the right atrium and superior vena cava (though patent). Thymoma was suspected, and proven later on biopsy
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F2
This mass was later confirmed to be a metastatic type B2, stage III thymoma via biopsy and after resection [Figure 2].