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Subiect: Mielom multiplu
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Elena (vizitator)


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07-02-2013 20:51 CitatCitat RăspundeRăspunde  
There is normal alignament of the lumbosacral spine. There is five non rib bearing vertebral segments. Conus medullaris demonstrate normal signal intensity and it terminates at T 12 - L1.. There is diffusely abnormal appearance of the vertebral bodies of the lumbosacral spine. There is also abnormal bone marrow singnal intensity of the lower thoracic spine and of the sacrim. There are multiple hypointense to intermediate signal intensity lesion within the vertebral bodies on T1 and T2 sequence. The lesion are of varying size and they are identified within the vertebral bodies and the posterior elements. The lesion demonstrate a hyperintense to intermediate signal intensity on STIR sequence. Superior vertebral endplate fractures are noted at T10, T11 and T12 vertebral bodies with 30%, 40% and 30% height loss respectively. There is bulging of the posterior wall of the T11 body. It is indenting the thecal sac, however, it is not causing central canal stenosis. There is expansion of the left T11 pedicle with resulting mild to moderate left neural foraminal stenosis. There are also fractures of the superior and inferior vertebral endplates of the L2 vertebral body with 20% height loss anteriorly and 40 to 50% height loss centrally. There is a superior vertebral endplates fracture of the L4 vertebral body with 30% height loss centrally. L3-L4: there is a minimal posterior disc bulge. There is no central canal stenosis or neural foraminal stenosis. L4-L5: there is a subtle posterior disc protrusion, asymetric to the left. No central canal stenosis or neural foraminal stenosis. Impression: diffusely abnormal appearsnce of the vertebral bodies of the lower thoracic spine, lumbosacral spine and the sacrum. The most significant involvement is seen at T11 where there is significant vertebral compression fracture and bulging of the posterior wall of the vertebral body. There is no central canal stenosis. There is however, mild left neural foraminal stenosis. The findings of MRI are suggestive of multiple myeloma. The differential diagnosis would include metastatic disease. Work up with CT of the chest, abdomen and pelvis, as well as electrophoresis of the proteins would be recommended.
Pacientul este de sex M, 44 ani, 88 kg. Antecedente canceroase in familie nu sunt cunoscute. Analizele la sange sunt in limite normale. Bence jonse lipseste in urina de 24 h. Durerea a debutat brusc acum 1 an de zile prin spasme musculare. S-au facut markeri tumorali la prostata, colon si inca cateva, si nu s-a gasit nimic.
Va rugam mult, daca puteti, sa ne spuneti daca sunt sanse mari ca diagnosticul pus de RMN sa fie adevarat. Multimim!
dr. Oana Iordache Utilizator offline
 
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10-02-2013 20:59 CitatCitat RăspundeRăspunde  
Aveti răspuns la o alta postare.
Medic Oana Iordache
Medcenter (www.medcenter.ro) - Info line 0800-800-599
Consultatii si investigatii in Bucuresti, Braila, Buzau, Cluj, Constanta, Galati, Iasi, Maramaures, Vrancea

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