KEY FACTS Terminology Neoplasm containing Schwann cells, fibroblasts, myxoid material, and peripheral nerve fibers Imaging Locations: Extradural/paraspinal, intradural extramedullary Variable involvement of spinal root, neural plexus, peripheral nerve, or end organs Different neurofibroma morphologies Localized Diffuse Plexiform Size varies from…
KEY FACTS Terminology Typical (“benign”) meningioma = WHO grade I Imaging Location Supratentorial (90%) – Parasagittal/convexity (45%), sphenoid (15-20%) – Olfactory groove (5-10%), parasellar (5-10%) Infratentorial (8-10%) (CPA most common site) Multiple meningiomas in 1-9% of cases General features Extraaxial…
KEY FACTS Terminology Neurinoma, neurilemmoma (outdated terms) Neoplasm of nerve sheath (Schwann cells) Imaging 70-75% intradural extramedullary Most common intradural extramedullary mass 15% completely extradural 15% transforaminal, “dumbbell” masses Size varies from small intradural mass to large intraspinal or paravertebral…
KEY FACTS Terminology Multifocal malignant proliferation of monoclonal plasma cells within bone marrow Imaging Skeletal survey is initial diagnostic imaging evaluation Diffuse osteopenia and multiple lytic lesions NECT (bone algorithm) Multifocal lytic lesions Vertebral destruction and fractures MR patterns Normal…
KEY FACTS Terminology Solitary monoclonal plasma cell tumor of bone or soft tissue Diagnosis of solitary bone plasmacytoma (SBP) requires Solitary lesion, biopsy showing plasma cells Negative skeletal survey, negative MR spine, pelvis, proximal femora/humeri Negative clonal cells in marrow…
KEY FACTS Terminology Extramedullary leukemic tumors Synonyms: Granulocytic sarcoma, chloroma Imaging Best diagnostic clue: Homogeneous enhancing tumor(s) in patients with known or suspected myeloproliferative disorder Meningeal (dural-based or pial) > intraparenchymal lesions NECT: Hyperdense CECT: Moderate uniform enhancement MR T2/FLAIR…
KEY FACTS Terminology Lymphoreticular neoplasms with myriad of specific diseases and cellular differentiation Imaging Multiple types with variable imaging manifestations Epidural lymphoma: Thoracic > lumbar > cervical Enhancing epidural mass ± vertebral involvement Osseous lymphoma: Long bones > spine Bone…
KEY FACTS Terminology Most common benign neoplasm of spine Vascular/fatty marrow with fewer but thicker trabeculae Imaging CT: Well-circumscribed, hypodense lesion with coarse vertical trabeculae (corduroy appearance on sagittal, “white polka dots” on axial CT) MR: Circumscribed lesion, hyperintense on…
KEY FACTS Terminology Spread of primary tumor to spine, where bone destruction exceeds bone production Imaging Multiple osteolytic lesions in spine Compression fracture with bowing of posterior cortex, osteolysis extending into neural arch, extraosseous soft tissue Lesion distribution proportional to…
KEY FACTS Terminology Extension of primary tumor to spine where bone production exceeds bone destruction Imaging Multiple osteoblastic lesions in spine May coexist with areas of osteolytic tumor, soft tissue mass Lesion distribution proportional to red marrow (lumbar > thoracic…