Female, 61 years old, history of non-Hodgkin's lymphoma with PET avid T11 lesion. Marrow signal intensity is diffusely heterogeneous on T1 and T2 weighted sequences but without significant STIR hyperintensity, unchanged from prior. Superimposed upon this background is a more localized region of abnormal low T1 and T2 signal within the anterior/superior T11 vertebral body, corresponding to the area of abnormal FDG uptake. This lesion shows no significant STIR hyperintensity. Relative to the prior examination, there has been no significant interval change.On postcontrast images, no convincing evidence of pathologic enhancement is seen to correspond with either the diffuse marrow heterogeneity, or the more localized signal abnormality within the T11 vertebral body. No pathologic epidural or intrathecal enhancement is seen.Spinal alignment is anatomic. Vertebral body height is preserved throughout. No evidence of significant degenerative disk disease, spinal canal or neuroforaminal stenosis is detected.The right adrenal gland remains mildly thickened. The left kidney contains a cystic lesion with a blood fluid level.
1. Diffuse heterogeneity of the marrow signal is redemonstrated, similar to the prior examination. This finding could reflect the presence of osseous lymphomatous disease. Lack of STIR signal abnormality or pathologic enhancement suggests, however, that the disease may be quiescent or treated. The possibility that these diffuse findings represent a treatment related marrow reconversion is felt to be less likely given the pattern of the abnormality.2. A more localized region of abnormal low T1/T2 signal within the T11 vertebral body is stable in size relative to the prior exam. Again, there is no corresponding STIR signal abnormality or pathologic enhancement. Nevertheless, given the CT findings, this remains concerning for localized tumor. 3. No epidural or intrathecal abnormalities are suspected. The spinal cord is normal.