Male, 65 years old, with worsening blurry vision, lymphoma, pancytopenia, EBV and CMV viremias. Also with urinary incontinence. Evaluate for epidural abscess, cord compression. Brain:Motion artifact degrades image quality on several sequences. No restricted diffusion is seen. No evidence of any significant parenchymal edema or mass effect is detected. There are no enhancing parenchymal or extra-axial lesions. No acute intracranial hemorrhage or any abnormal extra axial fluid collection is detected. The ventricular system is within normal limits.Lumbar spine:There are four fully lumbar type vertebral bodies and a transitional L5.A mild kyphotic angulation is seen at the L4-5 level, but elsewhere sagittal alignment is unremarkable. Vertebral body height and morphology are within normal limits.Innumerable small foci of enhancing marrow replacement are seen within the visualized marrow space of the lumbar spine and sacrum. The background marrow signal characteristics are otherwise relatively fatty in nature. Vertebral body height and morphology are within normal limits.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No pathologic intrathecal enhancement is seen. No epidural tumor or fluid collection is evident.Mild facet arthropathy develops at lower lumbar levels. This results in a significant transverse narrowing of the spinal canal at the L4-5 level. The L4-5 neural foramen and may also be mildly narrowed.Mild disc bulging and a right foraminal annular fissure are seen at L5-S1. Mild foraminal narrowing is also evident at this level but the spinal canal remains patent.Elsewhere, the intervertebral discs are preserved and there is no significant spinal canal or foraminal stenosis.
1.No significant intracranial findings are seen.2.No evidence of any epidural tumor or abscess in the lumbar spine. No abnormalities of the spinal cord or nerve roots are seen.3.Note is made of innumerable small foci of enhancing marrow replacement within the marrow space of the lumbosacral region. This is nonspecific and could represent an infectious or inflammatory process, lymphomatous involvement, or a reaction to stem cell transplantation.