Bloomy Rind Sign in Leptomeningeal Carcinomatosis Associated with EGFR-Mutated Lung Adenocarcinoma.

Authors

Makoto Hibino, Chiharu Samata, Hikari Higa, Shigehiro Watanabe, Riko Kamada, Shunichi Tobe, Kazunari Maeda, Shigeto Horiuchi, Tetsuri Kondo

Published in

Internal medicine (Tokyo, Japan). Oct 15, 2026. Epub Oct 15, 2026.

Abstract

We report two cases of leptomeningeal carcinomatosis (LMC) associated with EGFR exon 19 deletion lung adenocarcinoma, in which the "bloomy rind sign" on magnetic resonance imaging (MRI) provided supportive radiological evidence. In Case 1, the progression of MRI findings paralleled rising cerebrospinal fluid (CSF) carcinoembryonic antigen levels, exceeding serum concentrations despite persistently negative cytology. In Case 2, the sign appeared with recurrent intracranial hypertension and positive CSF cytology results. Despite treatment, both patients deteriorated in their condition. These cases suggest that the bloomy rind sign may raise suspicion of LMC despite unrevealing cytology; in Case 1, serial CSF CEA changes paralleled the clinical course of the patient.

PMID:
42875204
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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