Prolactinoma, history of brain cyst. Neck pain, back pain. MRI PITUITARY: There is expansion of the sella which is filled with CSF signal. There is enhancing soft tissue involving the sella anteriorly which likely represents normal pituitary gland which is anteriorly displaced. The small size of the pituitary gland limits assessment for pituitary microadenoma. There is however no appreciable micro or macro adenoma or any other suspicious sellar mass. There is minimal smooth enhancement involving the margin of the sella posteriorly and inferiorly. No mass effect on the optic chiasm. Infundibulum is midline. MRI CERVICAL SPINE: Examination is slightly motion degraded. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is benign.The cervical spinal cord has normal signal characteristics and overall morphology.Minimal degenerative changes are seen in the cervical spine with multilevel disc desiccation. Individual levels as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: Minimal disc osteophyte complex with effacement of the ventral thecal sac. No significant compromise to the spinal canal or neural foramina.C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.MRI LUMBAR SPINE:Examination slightly motion degraded. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. Fatty endplate changes are seen at the superior T12 level likely on a degenerative basis. The conus medullaris is normal in position.Individual levels as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild to moderate facet arthropathy.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild to moderate facet arthropathy.Paraspinous soft tissues are within normal limits.
1. Smooth expansion of the sella which is filled with CSF, and the pituitary gland is anteriorly displaced. Findings are compatible with a partially empty sella with suggestion of arachnoid cyst, although no perceptible cyst wall is appreciated. No prior MRI is available for comparison. There is no mass effect on the optic chiasm. There are no suspicious lesions involving the sella or evidence of microadenoma or macroadenoma.2. Minimal degenerative changes in the cervical spine without significant spinal canal or neural foraminal stenosis at any level.3. Mild degenerative changes in the lumbar spine without significant spinal canal or neural foraminal stenosis at any level. There is facet arthropathy at L4-L5 and L5-S1 which may be contributing to patient's back pain.