Advanced lung cancer. Mid back pain for 3 weeks. Evaluate for metastasis. There is diffuse fatty signal in the upper thoracic spine bone marrow related radiation treatment. The remainder of the marrow shows no significant focal lesion, aside from C7-T1 degenerative signal alteration. The vertebral bodies are preserved in height and the spinal canal is preserved. The spinal cord shows normal signal and is not compressed. The left upper lobe lung mass, which has intercostal extension, and an enhancing left pleural effusion are partially imaged. There also appear to be new enlarged retroperitoneal and mediastinal lymph nodes. There are T2-hyperintense nodules in the thyroid gland.
1.Postradiation changes are present in the upper thoracic spine, but no evidence of thoracic spine metastasis.2.Partially imaged left upper lobe lung mass with associated findings chest wall involvement and pleural effusion. 3.Possible new retroperitoneal and mediastinal lymphadenopathy. However, the MRI is not optimized for the assessment of these areas and a dedicated chest CT may be useful for further evaluation, if clinically warranted.4.Nonspecific thyroid nodules. A thyroid ultrasound may be useful for further evaluation.