Bloomy Rind Sign in Leptomeningeal Carcinomatosis Associated with EGFR-Mutated Lung Adenocarcinoma
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.
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BibTeX
@article{hibino2026bloomy,
title = {{Bloomy Rind Sign in Leptomeningeal Carcinomatosis Associated with EGFR-Mutated Lung Adenocarcinoma}},
author = {Makoto Hibino and Chiharu Samata and Hikari Higa and Shigehiro Watanabe and Riko Kamada and Shunichi Tobe and Kazunari Maeda and Shigeto Horiuchi and Tetsuri Kondo},
journal = {Internal Medicine},
year = {2026},
month = oct,
doi = {10.2169/internalmedicine.7924-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7924-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Bloomy Rind Sign in Leptomeningeal Carcinomatosis Associated with EGFR-Mutated Lung Adenocarcinoma
AU - Makoto Hibino
AU - Chiharu Samata
AU - Hikari Higa
AU - Shigehiro Watanabe
AU - Riko Kamada
AU - Shunichi Tobe
AU - Kazunari Maeda
AU - Shigeto Horiuchi
AU - Tetsuri Kondo
PY - 2026
DA - 2026/10/15
JO - Internal Medicine
DO - 10.2169/internalmedicine.7924-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7924-26/_article
AB - 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.
SN - 1349-7235
SN - 0918-2918
ER -