Male, 57 years old, with lower extremity weakness and pain, inability to walk. History of lung cancer. Concern for leptomeningeal spread. Patchy leptomeningeal enhancement is seen along a majority of the visualized spinal cord. In addition, more nodular, partially intramedullary enhancing deposits are seen along the left lateral cord at T3 and ventrally at T11 and T12. These nodular lesions produce moderate edema within the cord parenchyma.Spinal alignment is anatomic. Vertebral body heights are preserved. Marrow signal characteristics are heterogeneous, but there are no definite focal marrow replacing or enhancing marrow space lesions. The intervertebral discs are preserved. No significant spinal canal or foraminal compromise is seen. Right lung fibrosis and a chronic posterior right pneumothorax are partially visualized. Mediastinal and hilar adenopathy is also partially visualized.
Findings are seen compatible with leptomeningeal spread of disease. In addition, there are several more nodular tumor deposits which appear to be partly intramedullary and which induce moderate edema in the cord parenchyma.