 At the T2 level within the central compartment of the spinal cord is subtle abnormal T2 hyperintensity with a very subtle blush of enhancement. Evidence of enhancing lesions are also partially visualized in the posterior fossa on the recent outside hospital MRI with a dominant lesion in the right cerebellar hemisphere. The spinal lesion does not enhance to the extent of the intracranial lesions. The cervical spine is slightly straightened which is probably positional. The vertebral body and disk heights throughout the cervical, thoracic and lumbar spine are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical, thoracic or lumbar spine. The paraspinal soft tissues are unremarkable.Note is made of diffuse lymphadenopathy in the neck and mediastinum as well as pulmonary nodules bilaterally in the lungs. Status post splenectomy.
1.Abnormal T2 hyperintensity with a very subtle blush of enhancement at the T2 level of the spinal cord. Evidence of enhancing lesions are also partially visualized in the posterior fossa with a dominant lesion in the right cerebellar hemisphere. The spinal lesion does not enhance to the extent of the intracranial lesions but is likely of similar etiology. The differential diagnosis is broad and includes infection secondary to immunosuppression, a post infectious inflammatory phenomenon, direct reaction to medication, or a PTLD-like lymphoproliferative phenomenon.2.Diffuse lymphadenopathy in the neck and mediastinum as well as pulmonary nodules bilaterally in the lungs. The mediastinal lymphadenopathy and pulmonary nodules are better appreciated on the recent previous chest CT.