 Images are somewhat limited by patient motion. There is a background of severely heterogeneous marrow signal, scattered superimposed mildly expansile discrete metastatic osseous lesions which demonstrate STIR hyperintensity and T1 hypointensity, including posterior element involvement. There has been further progression of the now moderate-severe compression deformity involving T4. The most conspicuous lesions are again noted at the T9, T11, and T12 levels. There has been interval mild-moderate compression deformity involving T12. Dorsal epidural fat encroachment by tumor is suggested at T3, T9, T12, and possibly L1 levels. However, there is no evidence of acute cord compression. There is no significant retropulsion of fracture fragments any level, with mild to moderate scattered predominantly lumbar and to a lesser degree cervical spondylotic changes. There is likely most mild-moderate central spinal canal stenosis along the lumbar spine.In addition, metastatic lesions are seen at the C5-C7 levels within the cervical spine, as well as involving all the lumbar vertebrae. There is interval pathologic compression deformity of mild-moderate degree along the superior endplate of L5 where there is focal concavity compared to prior MRI, although this likely was present on the most recent CT chest.Scattered multilevel disc narrowing is present. The spine is in normal alignment. The spinal cord is grossly of normal caliber and signal.Due to the compression deformity of the T4, there appears to be mild-moderate bilateral foraminal narrowing at at T4-T5. There is moderate bilateral foraminal narrowing at L3-4 on the left as well as moderate right foraminal narrowing at L4-L5. At L5-S1, there is suggestion of mild bilateral foraminal narrowing.There is partial visualization of diffuse or hyperintensity throughout the pons, which is nonspecific.
1.Compared to prior available spine imaging, interval development of multiple discrete cervical and predominantly lumbar lymphomatous lesions, with redemonstration of several stable scattered thoracic lesions from lymphomatous involvement. Diffuse background of heterogeneous abnormal signal throughout the marrow.2.No acute cord compression. At most mild/moderate central spinal canal stenosis at several levels along the lumbar spine, with scattered dorsal epidural tumor as detailed above.3.Interval further collapse of the T4 vertebral body which is now moderate-severe in degree. Stable mild to moderate chronic compression deformity of T12 and more recent compression deformity of L5. No significant retropulsion of fracture fragments at any level.