Male, 66 years old, with multiple myeloma status post autologous stem cell transplant two years ago. Cervical:A well-circumscribed area of relatively T1 and T2 hyperintense signal is seen within the right aspect of the C4 vertebral body. This lesion correlates to a lucency on prior CT. Elsewhere, the cervical marrow signal is generally heterogeneous, but no definite additional focal lesions are seen.There are trace retrolistheses of C4 on C5 and C5 and C6. Spinal alignment is otherwise unremarkable. Slight loss of the C5 and C6 vertebral body height is noted. The visualized spinal cord demonstrates normal signal intensity and morphology.C2-3: Facet arthropathy. No significant spinal canal or foraminal stenosis. C3-4: Facet arthropathy. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate to severe left foraminal narrowing. C4-5: Facet arthropathy. Posterior disc-osteophyte complex formation. Mild spinal canal narrowing. Severe left and moderate right foraminal narrowing. C5-6: Mild posterior disc-osteophyte complex formation with mild spinal canal stenosis. Moderate bilateral foraminal narrowing. C6-7: Facet arthropathy. Minimal posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild left foraminal narrowing.C7-T1: No significant spinal canal stenosis or foraminal narrowing.Thoracic:Mildly heterogeneous marrow signal is seen. However, no discrete or focal lesions are detected. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. The spinal cord demonstrates normal signal intensity and morphology throughout. No epidural lesions are suspected. The intervertebral discs are preserved with no areas of significant canal or foraminal stenosis.Lumbar:Mildly heterogeneous marrow signal is seen. However, no discrete focal lesions are detected. Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. The distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural lesions are suspected. A focal cyst-like lesion with surrounding edema is partially visualized in the right sacral ala.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Facet arthropathy. Bulging disc. Mild spinal canal narrowing. No significant foraminal narrowing. L3-4: Facet arthropathy. Minimal bulging disc. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing. L4-5: Facet arthropathy and ligamentum flavum thickening. Mild bulging disc. Mild spinal canal narrowing. Severe right and moderate left foraminal narrowing. L5-S1: Facet arthropathy. Mild disc bulging. No spinal canal stenosis. Moderate bilateral foraminal narrowing.
No definite evidence of any active myelomatous lesions are seen. A fairly geographic lesion within the C4 vertebral body correlates to a lucent lesion noted on prior CT. The internal signal characteristics suggest at least partially fatty consistency which could indicate a hemangioma or perhaps a chronic, treated myelomatous lesion.A focal cystlike lesion with edema in the right sacral ala, partially visualized on this exam, could represent the sequela of recent bone marrow aspiration.