 There is an enhancing and expansile lesion involving both the body and odontoid process of C2 with disruption of the cortex. Extension of enhancing material is noted beyond cortical borders, especially on the left where there is a small amount of epidural material (however without significant associated mass effect upon the adjacent the thecal sac), as well as extending anterolaterally. This latter process abuts the left vertebral artery, which remains patent. This does not involve the adjacent disc level. Although it effaces the anterior CSF at the level of the odontoid tip, there is no cord abutment or displacement.A similar appearing, yet much smaller, process is also present within the T2 vertebral body. Although this may represent discogenic reactive endplate change, a secondary lesion cannot be excluded.A third, even smaller, process along the superior endplate of C6 has a similar appearance, yet location morphology is much more suggestive of reactive endplate change.There is diffuse marrow signal abnormality, specifically demonstrating T1 and T2 hypointensity which is not typical for a patient of stated age 65 years.The cervical and upper thoracic cord is normal in signal without abnormal enhancement. C2/3: UnremarkableC3/4: Posterior osteophyte disc complex and bilateral uncinate hypertrophy. Mild left neural foraminal stenosis.C4/5: Posterior osteophyte disc complex and bilateral uncinate hypertrophy. Mild right neural foraminal stenosis.C5/6: Posterior osteophyte disc complex and bilateral facet hypertrophy. Moderate bilateral neural foraminal stenosis.C6/7: Posterior osteophyte disc complex and bilateral uncinate hypertrophy. Moderate left neural foraminal stenosis.C7/T1: Unremarkable
1.There is an enhancing and expansile lesion involving both the body and odontoid process of C2 with disruption of the cortex. Extension of enhancing material is noted beyond cortical borders, especially on the left where there is a small amount of epidural material (however without significant associated mass effect upon the adjacent the thecal sac), as well as extending anterolaterally. This latter process abuts the left vertebral artery, which remains patent. This does not involve the adjacent disc level. Although it effaces the anterior CSF at the level of the odontoid tip, there is no cord abutment or displacement.2.A similar appearing, yet much smaller, process is also present within the T2 vertebral body. Although this may represent discogenic reactive endplate change, a secondary lesion cannot be excluded.3.There is diffuse marrow signal abnormality, specifically demonstrating T1 and T2 hypointensity which is not typical for a patient of stated age 65 years.4.These foci are most consistent with involvement from the patient's AML, and do not have the expected MRI appearance of osteomyelitis/diskitis or abscess.5.A third, even smaller, process along the superior endplate of C6 has a similar appearance, yet location morphology is much more suggestive of reactive endplate change.