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Cancer, pulmonary nodule, vertebral metastases (absent pedicle and lung mass)

Rexroad JR - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Civilian Medical Center

ABSTRACT

Diagnosis: Cancer, pulmonary nodule, vertebral metastases (absent pedicle and lung mass)

History: 53 y.o. man with cough and worsening mid-thoracic back pain for ten weeks

Findings: Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe. Also, the scout radiograph reveals absence of the T7 level pedicle on the right side. This secondary finding is confirmed on a frontal view of the thoracic spine. Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle. The paraspinal mass extends into the central canal and displaces the spinal cord to the left side. T1W MRI sagittal and axial images at the T7 level also show this finding of soft tissue signal replacing the right-sided pedicle. Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).

Ddx: 1. Absent pedicle in the presence of osseous metastatic disease 2. Primary tumor involving the posterior elements of the spine 3. Congenital absence of a pedicle

Dxhow: Imaging

Exam: N/A

No MeSH data available.


Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe.  Also, the scout radiograph reveals absence of the T7 level pedicle on the right side.  This secondary finding is confirmed on a frontal view of the thoracic spine.  Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle.  The paraspinal mass extends into the central canal and displaces the spinal cord to the left side.  Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).
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MPX1162_synpic35855: Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe. Also, the scout radiograph reveals absence of the T7 level pedicle on the right side. This secondary finding is confirmed on a frontal view of the thoracic spine. Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle. The paraspinal mass extends into the central canal and displaces the spinal cord to the left side. Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).


Cancer, pulmonary nodule, vertebral metastases (absent pedicle and lung mass)

Rexroad JR - MedPix

Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe.  Also, the scout radiograph reveals absence of the T7 level pedicle on the right side.  This secondary finding is confirmed on a frontal view of the thoracic spine.  Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle.  The paraspinal mass extends into the central canal and displaces the spinal cord to the left side.  Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1162&req=5

MPX1162_synpic35855: Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe. Also, the scout radiograph reveals absence of the T7 level pedicle on the right side. This secondary finding is confirmed on a frontal view of the thoracic spine. Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle. The paraspinal mass extends into the central canal and displaces the spinal cord to the left side. Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).

View Article: MedPix Image - MedPix Case

Affiliation: Civilian Medical Center

ABSTRACT

Diagnosis: Cancer, pulmonary nodule, vertebral metastases (absent pedicle and lung mass)

History: 53 y.o. man with cough and worsening mid-thoracic back pain for ten weeks

Findings: Frontal view of the chest obtained as a scout image prior to chest CT show a subtle mass-like opacity at the right upper lobe. Also, the scout radiograph reveals absence of the T7 level pedicle on the right side. This secondary finding is confirmed on a frontal view of the thoracic spine. Axial images from a CECT examination of the chest show a spiculated right upper lobe lung mass and, more inferiorly, a soft tissue mass is seen to replace the normal configuration of the right T7 pedicle. The paraspinal mass extends into the central canal and displaces the spinal cord to the left side. T1W MRI sagittal and axial images at the T7 level also show this finding of soft tissue signal replacing the right-sided pedicle. Subsequent fine needle aspiration of the paraspinal mass revealed poorly differentiated adenocarcinoma, presumed to represent metastatic lung cancer (biopsy of the right upper lobe mass was not performed).

Ddx: 1. Absent pedicle in the presence of osseous metastatic disease 2. Primary tumor involving the posterior elements of the spine 3. Congenital absence of a pedicle

Dxhow: Imaging

Exam: N/A

No MeSH data available.