MRI Cyst Question

[kelme]

Recently had head, thoracic, and lumbar MRI (symptoms -back pain, numbness face & hands & toes & back, along with dizziness).  Head clear, minimal disc bulge in lumbar, but thoracic showed multiple protruding bulges and stated the following:

In the anterior paraspinal region to the right of the midline at the T4 level is an oval area of near fluid signal characteristics.  This does not clearly erode the adjacent vertebral body and measures 7x10x6 mm. The exact nature of this is uncertain.  This likely represents a benign mediastinal duplication cyst. CT Imaging of the chest is recommended for confirmation.  

T4 level is the area at which my back pain is centralized.  I am scheduled for a cervical MRI and am scheduled for a chest CT to confirm cyst.  

I have two questions -
1. This may be a silly questions, but... I took a fish oil capsule probably an hour before I got the thoracic MRI and was wondering if this could be mistaken for a cyst if it were lodged in esophogus?

2. Could a small cyst in that area really cause these type of symptoms?

Thanks!

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

It is difficult for me to tell you the exact nature of the cyst as I can not see the imaging, and also intra-thoracic imaging is not my field. However, I will attempt to provide you with some answers to your questions.

First, while objects in the esophagus could potentially be mistaken for cysts, esophageal transit time in people with a normal esophagus is seconds to minutes; the fish oil capsule would likely have passed beyond the T4 level unless you have an esophageal motility disorder.

The report of your MRI indicates that the cyst is located in the anterior paraspinal region, meaning that it is sort of near the spinal column, but not within it, and the report indicates that there is not pressure or effect on the adjacent spinal column. Therefore, it would be unlikely to be causing neurologic symptoms directly.

I can not make definitive comments about whether or not the cyst is related to your symptoms, but it from the information you have provided, it seems to be unlikely. While a problem in the thoracic area could potentially explain your back pain and leg symptoms, it would not explain your hand pain, numb face, or dizziness, which are areas of the body that receive nerves from areas higher up than the thoracic area.

It sounds like you are definitely on the right track since you have a cervical MRI scheduled and the possible cyst is going to be further evaluated with a chest CT.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.