Peri-orbital and sclera swelling. Relapsed preB ALL s/p MRD SCT on blinatumimab. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is mild diffuse prominence of the sulci and ventricles, which may represent treatment-related pseudoatrophy. There is no midline shift or herniation. The major cerebral flow voids are intact. There is moderate mucosal thickening within the left maxillary and sphenoid sinuses and mild mucosal thickening within the right maxillary sinus. There is diffuse hypointense of the bone marrow on T1 and T2-weighted sequences.Orbits: There is left preseptal soft tissue swelling and and enhancement and to a lesser extent right preseptal swelling and enhancement. There is no evidence of abscess or postseptal inflammation. There is no evidence of intraorbital tumor. Spine: The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable.
1. Nonspecific left greater than right preseptal swelling, without evidence of abscess or postseptal cellulitis.2. No evidence of acute intracranial hemorrhage, mass, or acute infarct.3. No evidence of leptomeningeal tumor in the spinal canal.4. The diffusely abnormal bone marrow signal may be related to leukemia and/or associated treatment effects.