sb/bv
Date : 00.00.00

Name of the Patient : Abc Xyzlmn / F / 68 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Dorsal Spine.

CLINICAL PROFILE :

C/O severe pain in the left hemi-thorax since 5 days with breathlessness and fever.
Known hypertensive.

EXAMINATION :

M.R.I of the dorsal spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

8 mm thick T1 Weighted and T2 Weighted axial images.

5 mm thick Fast Scan (T2 *) coronal images.

OBSERVATION :

There is slight loss of water content of some of the dorsal intervertebral discs.

Posterior peridiscal osteophytes with posterior disc bulges are identified at the D11-D12, L1-L2 and L2-L3 levels.

The visualized dorsal vertebral bodies and the remaining intervertebral discs reveal normal signal intensity. The facet joints are unremarkable.

The visualized dorsal spinal cord reveals normal signal intensity. There is no cord compression.

The conus medullaris terminates at the L1-L2 level.


There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the pleural space and retrocrural space along the right posterior and lateral chest wall. This lesion appears hyperintense on the T2 Weighted images.

There are multiple, lobulated, soft tissue lesions in the subcarinal region, paraaortic region in the lower thorax, paraaortic, retrocaval and interaortico-caval regions in the visualized abdomen. These most likely represents enlarged lymph nodes.

Note is also made of mild splenomegaly.

Screening, T1 Weighted sagittal images of the lumbar spine reveal degenerative changes in the lower lumbar region with fatty changes of marrow. Multiple enlarged lymph nodes are also noted in the lumbar region.

IMPRESSION :

1. No significant abnormality is detected in the dorsal spinal cord and the dorsal vertebrae per se.

2. Pleural based lesion in the right hemithorax and retrocrural region with multiple enlarged lymph nodes in the subcarinal region, paraaortic region, retrocaval and interaortico-caval regions in the visualized abdomen
with splenomagaly as described is not specific for a single etiology. Small cell tumor or metastasis may be considered as differential diagnosis. The possibility of an infective etiology seems less likely.

It is difficult to assess involvement of the ribs in the right hemithorax.