My husband had an MRI in October 2020 with a diagnosis of multilevel degenerative disc disease with facet arthritis, spinal canal stenosis or neural foramina narrowing at multiple levels. He also has dextroscoliosis of lumbar spine and grade 1degenerative retrolithesis at multiple levels. L5-S1 is the most problematic level.
He also had the following finding: Multiple enhancing osseous lesions involving multiple vertebral bodies worrisome for osseous metastatic disease. The lesions were found at the L2, L5, and T-10 levels.
Next a CT Scan of the Abdomen and Pelvis showed: No definite suspicious osseous lesion. There is heterogeneity throughout the lumbar vertebral bodies however without discrete focal lesion.
MRI of the abdomen showed 1.2 cm enhancing lesion in the L2 vertebral body and partially visualized L5 vertebral body endplates enhancing lesion.
PET/CT from skull base to mid-thigh showed multiple avid osseous lesions mostly in the upper skeletal structures most likely representing bone marrow lesions in the absence of definite CT correlate.
His bone marrow biopsy showed no abnormal hematolymphoid population. No granulomas and no malignancy identified in the submitted tissue.
All workup for cancer was negative and he was discharged from oncology.
No one has been able to diagnose these lesions.
Could these lesions be modic 1 type changes, hematopoietic bone marrow, red marrow islands, or atypical hemangiomas?