 Again noted is a large destructive lesion of the left ilium which extends from the left sacroiliac joint to the left iliac crest, with associated heterogeneous T1 and T2 prolongation, consistent with the patient's diagnosis of plasmacytoma. Again seen is osseous destruction, appearing similar to the prior study. The lesion appears similar to minimally decreased in size and extent when compared to the prior study, however, direct comparison is suboptimal due to lack of intravenous contrast. The previously described soft tissue enhancement within the iliacus muscle is not able to be assessed on this noncontrast examination, however, there is increased signal abnormality on fluid sensitive sequences within the muscle that appears similar to the prior study. There is nonspecific subcutaneous edema along the lateral aspect of the iliac crest appearing similar to the prior study. No additional osseous lesions are identified.
Persistent left iliac lesion as described above appearing similar to minimally decreased in size when compared to the prior examination, compatible with the clinical history of plasmacytoma. No new osseous lesions are identified. Please see the dedicated MRI spine examination report for additional details. 