 MRI T-Spine:There is diffuse enhancement of the exiting thoracic spine nerve roots. There is no abnormal cord signal or enhancement involving the spinal cord. The thoracic spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There are is a small disc bulge at the T1-T2 level, small right paracentral disc protrusion, T2-3 level, tiny central disc protrusion at the T5-6 level but there is no significant spinal canal stenosis or neural foraminal narrowing. There are additional degenerative changes involving the T6-7 posterior T11-12 with variable disc height loss and Schmorl's nodes but no significant spinal canal or neural foraminal stenosis at these levels. MRI L-Spine:Within the thecal sac there is diffuse abnormal enhancement of the cauda equina nerve roots. The visualized lower spinal cord/conus is of normal signal intensity and enhancement.The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is a small disc bulge at L3-4 and L5-S1 with at most mild bilateral neuroforaminal stenosis at L5-S1 and no significant spinal canal stenosis at any level in the lumbar spine.
Diffuse enhancement of the cauda equina and thoracic spinal nerve roots. Given the patient's history, the possibility of lymphomatous involvement should be considered. An infectious or post-infectious-autoimmune process would also be in the differential.