Date : 00.00.0000
Name of the Patient : Abc Xyzaben lmn / F / 57 yrs.
Referred by : Dr. Abc Xyzhah.
Examination : M.R.I. of the Thorax/Cervico-dorsal Spine.
CLINICAL PROFILE :
Past H/O adenocarcinoma of thymus. Has received radiotherapy - 28 sittings.
M.R.I. of the thorax was performed using the following parameters:
8 mm thick T1 Weighted axial images and T2 Weighted (with fat saturation) coronal images.
The cervico-dorsal spine was examined with 5 mm thick T1 Weighted and T2 Weighted sagittal and axial images.
The dorso-lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.
There is seen an approximately 4.0 x 4.5 x 2.7 cms sized intermediate signal intensity mass lesion on the T1 Weighted images at the apex of the left lung in the left paravertebral/paratracheal region. This lesion appears relatively hypointense on the T2 Weighted images. There is collapse of the apical-posterior segment of the left upper lobe within air bronchogram/dilated bronchi. The collapsed lung is of intermediate signal on the T1 Weighted images and appears hyperintense on the T2 Weighted images. Resultant reduction in the left lung volume is noted with slight pull of the mediastinum to the left. Left sided apical pleural thickening is also noted.
Soft tissue is also noted in the anterior mediastinum which may be a part of the collapsed lung.
The trachea and the main bronchi show no intrinsic lesion. No obvious vascular anomaly is noted.
Screening images of the cervico-dorsal spine reveal collapse of the D6 vertebral body with a nearly hypointense signal on all the pulse sequences. The D5-D6 and D6-D7 intervertebral discs are unremarkable. There is no significant cord compression or cord signal alteration noted. The D1 to D9 vertebral bodies show spotty fatty marrow changes which may be the sequelae of previous radiotherapy.
Screening images of the dorso-lumbar spine reveal slight anterior wedging of the D12 vertebral body without significant change in the signal intensity or significant cord compression.
IMPRESSION :1. An approximately 4.0 x 4.5 x 2.7 cms sized mass lesion at the apex of the left lung in the left paravertebral/ paratracheal region as described is not specific for a single etiology. This lesion may either represent a recurrent/residual mediastinal mass, or may represent an enlarged, metastatic, mediastinal lymph node.
2. Collapse of the apical-posterior segment of the left upper lobe with apical pleural thickening.
3. Post-radiotherapy changes in the dorsal vertebrae as described.
4. Collapse of the D6 and D12 vertebral bodies may be due to osteoporotic changes rather than metastatic deposits. There is no cord compression or cord signal alteration noted.
No previous pretreatment investigations were available for review/comparison.