sb/bv/nl/rg.
Name of the Patient : Abc XyzLakdalmn / F / 60 yrs.
Referred by : Dr. Abc XyzDamania.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
Known C/O pleomorphic malignant lymphoma in the lumbo-sacral region. Received 6 cycles of chemotherapy and radiotherapy.
C/O swelling in the soft tissues of the back of neck and low back. Biopsy from the site s/o Non-Hodgkins lymphoma - follicular Grade I. On chemotherapy since 2 days.
EXAMINATION :
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
4 mm thick T1 Weighted coronal images.
5 mm and 6 mm thick T1 Weighted and T2 Weighted axial images.
OBSERVATION :
The exiting sacral nerve roots along the sacral foramina bilaterally appear slightly larger in diameter when compared to normal and show a hypointense signal on the T2 Weighted images. No soft tissue lesion is identified in the pre and paravertebral regions.
The L4 and L5 vertebrae and the sacral segments show a diffuse hyperintense signal on the T1 Weighted images which suggest fatty changes of the normal marrow, the sequelae of previous radiotherapy. Marrow inhomogenity is noted in the ala of the sacrum on the right.
Minimal posterior disc bulges are noted at the L4-L5 and L5-S1 levels, bilaterally.
Facetal hypertrophy is noted at the L4-L5 and L5-S1 levels bilaterally, with ligamentum flavum hypertrophy at the L5 vertebral level.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The intervertebral discs show loss of water content. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S2 level.
IMPRESSION :
In a known C/O pleomorphic malignant lymphoma, the MRI features suggest :
1. Post-chemotherapy/radiotherapy status.
2. Slight thickening of the sacral nerve roots as described which may be the sequelae of previous lymphoma.
3. Marrow inhomogenity in the ala of the sacrum on the right may be a residual lesion.
As compared to the previous MRI (study no:00009) dated 00.00.0000, the patient is now status post-radiotherapy. There is significant decrease in the size of the sacral intraspinal lesion and of the lesion in the right sacral ala.