Just Another Patient With Chronic Back Pain - Page #3
 

Lab Studies:
CBC w/ diff: Normal
CMP: Normal
LDH: Normal

Other Studies:
MRI T-spine: Case Photo #1
Abnormal infiltrative marrow process involving T11-T12 with adjacent soft tissue concerning for primary bone malignancy.

CT chest/abdomen/pelvis: Case Photo #2 , Case Photo #3 , Case Photo #4
Supraclavicular, mediastinal, and left retrocrural lymphadenopathy highly concerning for malignancy. Diffuse sclerosis of T11 vertebral body. Paraspinal soft tissue components with associated vertebral body erosion/lytic components. Extension into the bilateral neural foramina at T11-T12 and right neural foramina at T10-T11.

PET/CT:
Hypermetabolic adenopathy extending from the bilateral supraclavicular and level 4 cervical lymph node stations inferiorly to the retrocrural region with associated tumoral infiltration of the T11-T12 vertebral columns and posterior elements with resultant sclerosis.

Supraclavicular lymph node biopsy: Case Photo #5
Nodular Sclerosis Hodgkin Lymphoma

Consultations:
Oncology

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.


NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


Website created by the computer geek