Date : 00.00.00
Name of the Patient : Abc Xyzhar Mlmn / M / 31 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of the Sacrum.
CLINICAL PROFILE :
C/O backache with swelling since 1 year.
C/O radicular pain to BUE and BLE with bladder involvement since 00.00.00
M.R.I of the sacrum was performed using the following parameters:
5 mm thick T1 Weighted and T2 Weighted sagittal images.
7 mm thick T2 Weighted (with fat saturation) sagittal images.
10 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
7 mm thick T1 Weighted and STIR coronal images.
There is evidence of a fairly well-defined, lobulated mass lesion involving the sacrum from the S2 level downwards. Anteriorly it is seen to extend into the pelvis with displacement of the rectum anteriorly and to the left. Posteriorly it is seen to extend into the posterior paraspinal soft tissues. The sacro-iliac joints per se do not seem to be involved by the lesion.
This lesion is of intermediate signal intensity on the T1 Weighted images and turns hyperintense on the T2 Weighted and STIR images. Also seen within this lesion are areas of hyperintensity on the T1 Weighted images and which show intermediate signal characteristics on the T2 Weighted and STIR images. This may represent proteinacious material/paramagnetic substances or bone.
A catheter is noted within the urinary bladder.
The MRI features are suggestive of a mass lesion arising from the sacrum from the S2 level downwards as described.
The differential diagnosis would include :
Neoplasia like :
a. Small cell tumors like a plasmacytoma or lymphoma.