Malignant (primary) neoplasm, unspecified [C80.1] / Human immunodeficiency virus (HIV) disease [B20] / Secondary malignant neoplasm of bone [C79.51] / Disorder of bone, unspecified [M89.9], Reason for Study: ^Reason: cord compression protocol - rule out Cervical MRI:Motion artifacts degraded exam quality.There is normal cervical lordosis. The cranial-cervical junction is normal.Spinal cord signal intensity is normal.There are focal protrusion of discs without creating spinal stenosis at the level of C45 (central to left) and C56 (central to right) level.There is an enhancing mass on the left side paravertebral muscle (21.6mm x 19.8mm) indicating possible lymph node enlargement or muscle mass.Vertebral bodies appears to be within normal limits.Thoracic MRIThere is normal thoracic kyphosis and spine alignment is normal.Spinal cord signal intensity is normal.There is T2 high signal intensity lesion at T10 vertebral body which most likely represent hemangioma. There is irregular shaped enhancing mass lesion on the left side of upper mediastinum which is adjacent to the junction of aortic arch and descending aorta as well as proximal subclavian artery suggesting possible malignant lesion. Dedicated imaging study such as Chest CT scan with enhancement can be considered for further imaging evaluation.No evidence of cord compression.Lumbar MRINormal lumbar lordosis. The spine alignment is anatomic.No evidence of spinal cord compression. The conus medullaris terminates at the level of T12-L1. There is 16.9mm x 18.5mm left adrenal gland nodule. The clinical significant of the lesion can be assessed with dedicated adrenal gland imaging, please consult to abdominal imaging department.There is evidence of soft tissue mass replacing cortical bone on the left side pedicle of the L1 vertebral body with the mass extension toward posterior aspect of the L1 body. The mass appears to be extended toward the left side neuroforamen. There are multifocal vertebral body marrow replacing lesions including L2 vertebral body left side, S1 vertebral body and right side ilium, most likely represent metastatic lesion.This lesion is consistent with metastatic lesion.
1. No evidence of spinal cord compression.2. Multiple enhancing soft tissue mass lesions including left posterior upper mediastinum, left adrenal gland and left side pedicle with L1 vertebral body indicating possible metastatic lesions.3. Soft tissue masses on the L2, S1 and right side ilium indicating possible metastatic lesions. Comment: considering multiple bony and adrenal metastatic lesions, dedicated imaging studies such as adrenal gland imaging and lumbar spine or pelvic imaging can be considered.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.