Correct!
All of the above

At this point she has definite neurologic symptoms and physical findings with a negative neurologic radiographic and laboratory workup. The MRI was repeated and showed “progressive pachymeningeal and leptomeningeal inflammatory process - left side dominant”. A repeat LP had findings as below:

• Normal opening pressure
• Clear fluid
• Glucose-within normal limits
• Protein-within normal limits
• Cell count 4-WBCs/mm3  
• Lyme PCR-negative
• HSV-negative
• ACE-normal

Thoracic chest CT is below (Figure 1).

Figure 1. Representative images from the thoracic CT scan lung windows (A-C) and mediastinal windows (D-F). Movie of thoracic CT images lung windows (Panel G, lower left) and medistinal windows (Panel H, lower right).

Which of the following best describe(s) the CT scan?

1. No enlarged mediastinal lymph nodes
2. Normal lungs
3. Small pulmonary nodules predominately in the lower lobes
4. Subcarinal mediastinal lymphadenopathy
5. 1 and 3
6. 2 and 4

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