my boyfriend was admitted to a hospital on thursday with a headache and right upper extremity chest xrays lobulated left upper lobe lesions head ct finding compatible with brain metastases mri of brain bilateral enchancing lesions and primary differential diagnosis cinsideration would be of multiple metastatic lesions with vasogenic edema in a patient with a lung mass plan betamethasone 2. antiseizure medication neuro check pulmonary and onocology evualtion suportive care ct head w/o contrast there is a 28 mm mass with significant vasogenic edema in the posterior aspect of the right temporal lobe there is a 16 mm mass with the vasogenic edema in the left centrum semiovale impressions findings compatible with brain metasasis ct chest and abdomen & pelvis there is a large 5 cmm in teh left upper lobe with extension to the pleural surface this is not calcified primary differential diagnostic consideration would be that of milgnancy the examination demonstrates rounded 2 cmm dentisty in the left adrenal gland and in light of above described lung mass primary differential diagnostic would be tha of adrenal metastasis conclusion large left upper lobe mass and primary differential diagnostic consideration would be that of carcinoma there is associated left adrenal lesion as well mri brain w/o contrast the examination again demonstrates the previously described lesions in the right temporal lobe and left centuem semiovale there is irregular enchancement of both lesions the larger lesion in the rigth temporal region demonstrates 3.5 cm area of enchament and in the left lesion lesion a 1.5 cm area of enchament there is associated vasogenic edema xr chest 1 view portable findings there is a lobulated soft tissue mass in the left upper lobe abutting the rib cage measuring about 60x 35 mm the lung s are clear there are no pleural effusions cardiac silhoutte appears normal the osseous structures appear grossly intact i need someone to talk to me in terms i can understand so i can help him make the best decision