71-year-old male with history of thoracic soft tissue mass. Additional clinical history of prior radiology requisitions indicates myeloma and prostate cancer.IMAGE ACQUISITIONS: CT of the thoracic and lumbar spine was performed without the administration of IV contrast. On this nonenhanced CT examination, there is no gross soft tissue abnormality to suggest a mass. The paraspinal soft tissues appear normal. However, this type of examination is not optimal for detection of soft tissue masses, and if there is continued clinical concern, MRI is recommended for a better evaluation of the soft tissues.Within the thoracic spine, there are diffuse bone changes of myeloma. There is kyphosis at the level of the severe compression fracture of the T5 vertebral body. Severe compression deformity of the T12 vertebral body is also present. T11 is status post vertebroplasty. More mild compression deformities are seen at the T7, T8 and T 11 levels.Within the lung bases, there is patchy opacity with air bronchograms which could be infectious in etiology.LUMBAR SPINE
1. No definite soft tissue mass. If there is continued concern for soft tissue mass, MRI is recommended for a more sensitive evaluation.2. Extensive changes within the bony spine consistent with the history of myeloma. Numerous compression fractures throughout the thoracolumbar spine.3. Opacity within the lungs which could represent pneumonia.