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Case Reports
. 2024 May 14;12(5):e8932.
doi: 10.1002/ccr3.8932. eCollection 2024 May.

Extraordinary linear non-enhancing brainstem leptomeningeal metastasis from lung adenocarcinoma: A case report

Zhibin Tan  1 , Shawn Zhi Zheng Lin  1 , Yihan Li  2 , Si Wei Kheok  3
Affiliations
Case Reports

Extraordinary linear non-enhancing brainstem leptomeningeal metastasis from lung adenocarcinoma: A case report

Zhibin Tan et al. Clin Case Rep. .

Abstract

In patients with lung adenocarcinoma, angiogenesis-altering drugs can alter the appearance of leptomeningeal metastasis on magnetic resonance imaging (MRI) scans. In the ventral brainstem, this can manifest as a unique, linear, non-enhancing T2-hyperintense signal.

Keywords: adenocarcinoma; brain; lung; magnetic resonance imaging; metastasis; tyrosine kinase inhibitors.

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Conflict of interest statement

The authors declare that there is no conflict of interest, no affiliation or financial involvement with any commercial organizations, and no financial interest in the subject or materials discussed in the manuscript.

Figures

FIGURE 1
FIGURE 1
Magnetic resonance imaging of the brain showing “bloomy rind sign.” (A, B) T2 fluid‐attenuated inversion recovery sequences, showing linear hyperintensities outlining the anterior aspects of the pons and middle cerebellar peduncle, respectively. (C, D) Diffusion weighted sequences, showing restricted diffusion over the same areas. (E, F) Apparent diffusion coefficient sequences, showing hypointensity over the same areas. (G, H) Gadolinium‐enhanced T1 sequences, showing lack of abnormal enhancement over the same areas.
FIGURE 2
FIGURE 2
Cerebrospinal fluid cytology showing malignant cells consistent with metastatic lung carcinoma. (A, B) Papanicolaou and Diff‐Quik stains showing atypical cells (arrows) with enlarged irregular nuclei and hyperchromasia, respectively. (C) Thyroid transcription factor‐1 (TTF‐1) immunostain performed on cytospin highlighting few atypical cells (arrow), consistent with a lung origin.
See this image and copyright information in PMC

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