Abnormal MRI: Second Opinion in Order?

[An__0__0]

  I am a 48 year old female. Recent MRI showed "Focal areas of increased intensity within the periventricular and deep white matter, raising concern for multiple sclerosis; other demyelinating diseases and lupus cannot be excluded."
  Neurologist who reviewed scan did not think it indicated MS or CNS vasculitis because the bright spots on T2-weighted images, although numerous, are small and nonspecific; instead just recommended clinical monitoring by primary care physician. History includes: diplopia of 4 years duration, following sudden onset (treated with prisms in glasses); debilitating and progressively worsening headaches, usually upon awakening; mild memory loss (free-recall, as documented in formal testing); recurring skin nodules thought to be erythema nodosum; mild intermittent hypertension (treated with beta blocker); mild elevation of prolactin levels (35) despite bromocriptine treatment; infrequent falls (3 in last 6 months); carpal tunnel in both arms; intermittent severe leg pain; hematuria of 6 months duration. Although I am a well-educated professional, I have recently been having trouble at times writing the words I intend to write. I am receiving mixed signals from health providers on the seriousness of the MRI findings. Testing to date has included: MRI, memory testing, prolactin blood level, and thyroid test.
  Does this sound like MS or lupus? Is there any chance this could be some type of infiltrating astrocytoma or metastasis from a cancer elsewhere? (Only know these terms because of reading I have done in connection with my young son's brain tumor). Is a 2nd opinion needed? If so, by what kind of doctor? Evaluation by an MS Center needed? The "wait and see" approach is a little frustrating to me at the moment because of the seemingly steady progression of symptoms, which at times are quite debilitating. Any advice will be greatly appreciated! Thank you.          
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The short answer here is that this could be either, if the people looking
at the scans cannot tell the diference simply reading a narrative of the
findings will not yield a better opinion.
It does sound like this is a very frustrating process for you so a second
opimion fron a neuro-immunologist would certainly be in order.
The great bulk of a neuroimmunologists work is made up of looking after
MS patientd but the also see people with CNS involvement due to other
processes like lupus so this subspecialty would be the ideal place to go
looking for another opinion and if necesary futher work-up.
Appointments for the neuroimmunology dept at the Cleveland Clinic can be
contacted at (216) 444 559 , the dept is based in The Mellen Center for
Multiple Sclerosis.
I think the possibility of this being due to a tumor is non-existant.