Spine Week 13 Case 12

• There is gross generalised reduction of marrow signal throughout the spine on all pulse sequences, the features being consistent with severe marrow reconversion. Also, there is a small lobular mass demonstrated anterior to the S4-S5 disk which has identical signal characteristics to the underlying bone marrow and may represent an area of extramedullary haematopoiesis. The lesion measures in the region of 15 x 11 mm in dimension. There is also a large left paravertebral mass adjacent to the T9-T10 vertebrae on the left side which again has a identical signal characteristics to the underlying bone marrow and measures approximately 7 cm in length and 5.6 cm in transverse dimension. Once again, this would be quite consistent with extramedullary haematopoiesis. Several small paravertebral masses are identified bilaterally adjacent to the major lesion.
• Conclusion: severe red marrow reconversion with extramedullary haematopoiesis. The most likely differential is thalassaemia.