Date : 00.00.00
Name of the Patient : Abc Xyzp Glmn / M / 19 yrs.
Referred by : Dr. Abc Xyzvade.
Examination : M.R.I. of the Dorso-lumbar Spine.
CLINICAL PROFILE :
C/O backache with swelling since childhood.
M.R.I of the dorso-lumbar spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
7 mm thick T1 Weighted and T2 Weighted axial images.
5 mm thick T1 Weighted coronal images.
There is slight anterior wedging of the D10 and D11 vertebral bodies with an angular kyphus at this level.
There are erosions with replacement of the normal marrow of the left pedicle and the transverse process as well as the spinous process and the lamina of the D7, D8, D9, D10 and D11 vertebral bodies by hypointense areas on the T1 Weighted images. These are seen to turn heterogenously hyperintense on the T2 Weighted images. There is a left paravertebral soft tissue lesion extending over the D7 to the D10-D11 levels with involvement of the costo-vertebral and costo-transverse joints over these levels. There is encroachment into the D7-D8, D8-D9, D9-D10 and D10-D11 neural foramina on the left side with small lateral epidural extension. There is extension into the paraspinal soft tissues bilaterally over the D4 to the L2 levels. This lesion is slightly hyperintense to the muscles on the T1 Weighted images and turns hyperintense on the T2 Weighted images. Septae are noted within this lesion.
The rest of the visualized dorso-lumbar vertebral bodies and intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.
The visualized dorsal spinal cord reveals normal signal intensity. There is no cord compression.
The conus medullaris terminates at the L1 level.
The MRI features are suggestive of altered signal of the D7, D8, D9, D10 and D11 vertebral bodies with extensions as described is
not specific for a single etiology.
The possibilities to be considered are,
1. A nerve sheath tumor in view of the presence of the lesion since birth. The possibility of malignant degeneration within this lesion should be excluded.
2. Soft tissue sarcoma though less likely.
3. An infective lesion seems less likely.