Refractory multiple myeloma SKULL: Multiple lucent myelomatous lesions are seen throughout the skull, similar in extent to the prior exam.CERVICAL SPINE: An equivocal lucency is seen within the C2 vertebral body which may represent a myelomatous deposit. Degenerative arthritic changes of cervical spine are similar to the prior exam.THORACIC SPINE: The bones are demineralized which may reflect widespread myelomatous deposits. There is a severe compression deformity of T9 which is new compared to the prior examination but was evident on interval CT and MRI dated 7/10/2016. Compression deformities of T3, T8, and T11 appear similar to the prior exam.LUMBAR SPINE: There is new mild superior endplate depression of L4 with poor visualization of the anterior cortex which may reflect myelomatous involvement. A lucency within the L5 vertebral body may also represent a myelomatous deposit or overlying bowel gas. Degenerative arthritis of the lumbar spine is similar to the prior exam.RIBS: There are multiple rib deformities likely representing healing pathologic fractures resulting from myelomatous involvement. Overall this appears similar to the prior exam. A myelomatous lesion of the left distal clavicle also appears similar to the prior exam.PELVIS: Again seen are multiple lytic lesions of myeloma, similar to the prior exam accounting for positional and technical differences.UPPER EXTREMITY: Right humerus: There are multiple lucent lesions of myeloma, similar to the prior exam accounting for positional differences.Left humerus: There are multiple lucent lesions of myeloma including a focus within the distal humeral diaphysis which appears enlarged from the prior exam.Right forearm: There are multiple lucent lesions of myeloma appearing similar to the prior exam.Left forearm: There is a small lucency within the distal radius which may reflect a myelomatous deposit although this is equivocal and unchanged from the prior exam.LOWER EXTREMITY: Right femur: There is a small, poorly defined lucency within the femoral diaphysis appearing similar to the prior exam and likely representing a myelomatous deposit.Left femur: Multiple lucent lesions of myeloma identified within the femoral neck and diaphysis appearing similar to the prior exam.Right tib-fib: There is a lucency within the medial condyle of the proximal tibia which may represent a myelomatous deposit and in retrospect was present on the prior exam. There is a tiny lucency within the distal fibular diaphysis which may represent a myelomatous deposit and was not present on the prior exam.Left tib-fib: There is a lucency within the mid fibular diaphysis likely representing a myelomatous deposit and is similar to the prior exam.
Multiple myeloma as described above with findings suggestive of mild progression.