47-year-old female with a history of large B cell non-Hodgkin's lymphoma status post 6 cycles of chemotherapy. Evaluate left scapula mass/lesion. There is heterogeneous signal abnormality affecting the scapula. Again seen is deformity and fragmentation of the scapula, particularly along the inferior and medial aspect of the glenoid, consistent with the patient's history of osseous destruction complicated by pathologic fracture. Note is made of a 9 mm focus of pathologic enhancement along the lateral border of the body of the scapula suspicious for residual osseous disease (image 15; series 15). Additionally, note is made of multiple subcentimeter foci of enhancement within the subscapularis muscle belly which are also suspicious for residual tumor/disease. There is a 3.1 x 1.8 x 2.7 cm left axillary mass/lymphadenopathy with thin peripheral enhancement. There is nonenhancing increased signal abnormality within the deltoid, subscapularis, supraspinatus, and infraspinatus which is nonspecific and may reflect post therapy change versus subacute denervation. The visualized musculature is otherwise within normal limits. There is a small amount of fluid within the glenohumeral joint with associated thick enhancement suggesting a synovitis.
Enhancing scapular lesion suspicious for residual osseous disease as described above. Persistent left axillary mass as well as enhancing foci within the subscapularis muscle which are also suspicious for residual disease. Other findings as described above.