Male, 75 years old. Reason: eval for further mets History: thoracic spine with lytic lesion, bx with plasmacytoma SKULL: Tiny lucencies in the calvarium may simply represent vascular markings. We see no definite myelomatous lesions.CERVICAL SPINE: The lower cervical spine is not well-seen on the lateral view due to overlying anatomy. Given these limitations, we see no lytic lesions. Severe degenerative disc disease affects the lower cervical spine. There is moderate multifocal facet joint osteoarthritis.THORACIC SPINE: The left pedicle of T9 is indistinct, corresponding to the lesion seen within the T9 vertebra on prior MRI. We see no additional lesions within the thoracic spine. There is multilevel degenerative disc disease. LUMBAR SPINE: The bones appear demineralized diffusely, but focal vertebral body lesions are much better seen on recent MRI study. Severe degenerative disc disease affects the lumbar spine.RIBS: Rib lesions seen on recent CT scan are not clearly evident on this study. The lower ribs are partially obscured by enteric contrast in the colon. Surgical clips and stents are noted in the mediastinum.PELVIS: Portions of the pelvis are obscured by overlying enteric contrast. Myelomatous lesions are better visualized on recent CT scan. Surgical clips overlie the left groin region.UPPER EXTREMITY: Two views of the right humerus show multiple lucent lesions concentrated in the proximal diaphysis compatible with myeloma. One view of the right forearm shows small lucencies in the proximal radial and ulna that may represent foci of myeloma. Two views of the left humerus show multiple lucent lesions within the diaphysis, compatible with myeloma. One view of the left forearm shows no definite myeloma lesions.LOWER EXTREMITY: Two views of the right femur show poorly defined lucencies in the proximal diaphysis, compatible with myeloma. Moderate osteoarthritis affects the right knee. Two views of the left femur show poorly defined lucencies within the femoral diaphysis, compatible with myeloma. AP views of the lower legs show no definite myelomatous lesions. Surgical clips are noted within the soft tissues of the right leg.
Widespread multiple myeloma as described above.