Sacral lesion, leukemia There is diffuse signal abnormality and enhancement involving the bones of the pelvis likely representing diffuse leukemic infiltration. There is a curvilinear enhancement pattern of the iliac bones and sacrum also suggesting the presence of bone infarctions which are more evident on the current exam than the prior. There is dural enhancement of the visualized spinal canal but we see no discrete mass lesion. There is extensive subcutaneous edema and mild intra- and intramuscular edema in the pelvis and proximal thighs appearing similar to the prior exam. The muscles of the pelvis and upper thigh demonstrate mild generalized atrophy as well. There is also edema and enhancement of the paraspinal musculature posteriorly which is nonspecific but again no discrete mass is appreciated. We see no hip joint effusion or synovitis.Please refer to the corresponding lumbosacral MRI for further details regarding the spine.
Marrow signal abnormalities as described above likely reflecting a combination of leukemic infiltrate and bone infarctions. Although there is mild dural enhancement, there is no discrete spinal or sacral mass.