PMC10238830_01
CT head with IV contrast shows a peripherally enhancing lesion in the left parasagittal frontal lobe measuring 2 x 2x2 cm.
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Chest x-ray showed pulmonary vascular congestion and CT head with intravenous contrast (IV) was significant for a 2 cm left parasagittal frontal lobe lesion (Fig. 1) suspicious for an abscess.
MRI brain with and without IV contrast shows leptomeningeal disease in the subfalcine and arachnoid spaces extending into the cingulate sulci and supracallosal arachnoid spaces (2A) and multiple lobulated foci within the arachnoid spaces and surrounding cortical tissues consistent with an arachnoid space empyema and multiple focal cortical gray matter abscesses (2B).
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Further studies with magnetic resonance imaging (MRI) of the brain with and without IV contrast showed subfalcine and supracallosal diffuse enhancements suggestive of leptomeningeal disease (Fig. 2A) with multiple lobulated foci within the arachnoid spaces consistent with an arachnoid space empyema and multiple focal cortical gray matter abscesses (Fig. 2B), while CT chest, abdomen, and pelvis with IV contrast (Fig. 3) showed bilateral pulmonary patchy ground glass opacities, a large hepatic hyperdensity, bilateral renal cortical cysts, and retroperitoneal lymphadenopathy.
CT chest, abdomen, and pelvis with IV contrast shows bilateral patchy ground-glass opacities, a large area of ill-defined hyperdensity in the right lobe of the liver, bilateral renal cortical cysts, and retroperitoneal lymphadenopathy.
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Further studies with magnetic resonance imaging (MRI) of the brain with and without IV contrast showed subfalcine and supracallosal diffuse enhancements suggestive of leptomeningeal disease (Fig. 2A) with multiple lobulated foci within the arachnoid spaces consistent with an arachnoid space empyema and multiple focal cortical gray matter abscesses (Fig. 2B), while CT chest, abdomen, and pelvis with IV contrast (Fig. 3) showed bilateral pulmonary patchy ground glass opacities, a large hepatic hyperdensity, bilateral renal cortical cysts, and retroperitoneal lymphadenopathy.
MRI brain with and without IV contrast shows interval changes with improvement of the enhancing abnormalities.
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