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CASE

A 67 year-old male is admitted with global aphasia and right-sided weakness. A few hours later, he develops left-sided weakness. Around two months ago, he was diagnosed with lung cancer. The biopsy showed an adenocarcinoma. His wife has also noticed a rash affecting both legs (see image below). MRI DWI and ADC images of the brain are also shown. In addition, a CT angiogram shows several areas of dilatation and stenosis affecting branches of the middle and anterior cerebral arteries bilaterally. What is the most likely diagnosis?

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A. Cerebral metastases

B. IgA vasculitis

C. Infective endocarditis 

D. Microscopic polyangiitis

E. Polyarteritis nodosa

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