VHL and history of multiple hemangioblastoma; evaluate for growth and new lesions History: 54 yo female with VHL and history of multiple hemangioblastoma; evaluate for growth and new lesions. There is evidence of posterior element resection at most levels of the cervical spine. There is no evidence of spinal cord lesions. The cervical lordosis is mildly straightened. The vertebral body heights are preserved. Level specific findings are as follows:C2-3: There is no spinal canal stenosis or neuroforaminal narrowing. C3-4: There is a small posterior disk osteophyte, but no significant spinal canal stenosis or neural foraminal narrowing.C4-5: There is a small posterior disk osteophyte, but no significant spinal canal stenosis or neural foraminal narrowing.C5-6: There is posterior disk osteophyte formation along with ligamentum flavum thickening, which results in a moderate spinal canal stenosis, as well as severe left and moderate right neural foraminal narrowing. C6-7: There is left facet hypertrophy and a small posterior disk osteophyte, but no significant spinal canal stenosis. However, there is moderate left and mild right neural foraminal narrowing. C7-T1: There is no significant spinal canal stenosis or neural foraminal narrowing. Thoracic spine: The thoracic kyphosis is mildly exaggerated at T12 secondary to mild vertebral body wedging without change. The bone marrow signal is unremarkable. There is no definite evidence of any spinal cord signal abnormality. There is a small central disk protrusion is present at T8-9 along with a left paracentral protrusion at T11-12. There is no significant spinal canal or neuroforaminal stenosis. There are innumerable bilateral renal and pancreatic cystic lesions, some of which contain heterogeneous material and/or fluid-fluid levels. The findings appear similar to those seen on the prior examination, though this examination is not adequate for assessment of individual lesions.
1. Degenerative spondylosis at multiple levels of the spine, but bi definite evidence of hemangioblastomas in the imaged spinal cord, although the lack of intravenous contrast limits evaluation.2. Innumerable bilateral renal and pancreatic cystic lesions are compatible with stigmata of VHL.