I just received my follow up MRI appointment with my physician. I am a 37 year old woman with 12+ year history of numbness/tingling in both arms/hands, cervical neck pain with secondary spasms in the neck area. MRI findings state abnormal bone marrow in right facet of C4 with 11mm area of bright signal on T2-weighted sagittal series image. States not typical of hemangioma and with my age and no history of malignancy, radiologist states most likely benign finding such as an atypical hemangioma. No cortical destruction or associated soft tissue mass. Axial series shows right facet expanded compared to the left facet, with right facet measuring 9mm. Radiologist states this could be a more significant benign primary bone tumor. I am scheduled for a thin slice CT on 4/15/08 to compare with MRI findings.
I also have minimal left paracentral disc protrusion on C4-C5 with no significant foraminal stenosis. At C6-C7, a finding of central disc protrusion without cord compression and cord appears normal. Bilateral cervical lymph nodes are at upper limits of normal in size
Impression: approximately 1cm bone tumor in right C4 facet, more likely benign than malignant due to my age, history and expansile rather than destructive appearance on MRI. Radiologist states this is not a typical hemangioma but may be an atypical hemangioma.
My questions are as follows:
1. is the only way to determine the cause of my enlarged cervial lymph nodes to do an ultrasound or biopsy? This is what I have read thus far.
2. In reference to my abnormal bone marrow in the right facet C4, how will it be determined what the cause is? What does this abnormal bone marrow mean exactly?
3. I read that hemangiomas do not usually cause back pain unless they are growing and/or malignant. I have had chronic and intermittent pain in my upper back/throughout my scapulae and up to the middle of my back of my head, sometimes severe enough where I had to go to the E.R. for pain relief, for the better part of 10+ years. I also read that without a tissue diagnosis, the atypical hemangioma can not be determined if it is simply normal. Can you explain or give me information on this issue.
4. After my CT, what is next? What can I look forward to if the CT shows similar findings to the MRI?
Incidentally, I spoke with my mother and she said she had similar issues as above before. Could this be hereditary?
Thank you for your attention and time to answer my questions.
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