title: Importance of MRI in the diagnosis of vertebral involvement in generalized cystic lymphangiomatosis.
abstract: A 9-year-old boy presented with the sudden onset of pleuritic chest pain and on CT was found to have a large pleural effusion, mediastinal fluid, splenic lesions and multiple apparently sclerotic vertebral bodies. Subsequent MRI showed that those vertebral bodies that appeared sclerotic were in fact normal, and the vertebral bodies initially interpreted as normal had an abnormal T1 and T2 hyperintense signal on MRI and were relatively lucent on CT. MRI also demonstrated abnormal heterogeneous T2 hyperintense paraspinal tissue and several multicystic soft tissue masses. Biopsy of two adjacent vertebral bodies, one relatively sclerotic and one lucent, demonstrated findings of bony remodeling without a specific diagnosis. Biopsy of an infiltrative mediastinal mass confirmed the diagnosis of generalized cystic lymphangiomatosis. MRI should be included in the assessment of vertebral involvement in this condition because CT and biopsy findings may be nonspecific.
authors.affiliation: Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Renjen
authors.forename: Arzu
authors.initials: A
authors.lastname: Kovanlikaya
authors.forename: Navneet
authors.initials: N
authors.lastname: Narula
authors.forename: Paula W
authors.initials: PW
authors.lastname: Brill
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D018191:Lymphangioma, Cystic / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013125:Spinal Neoplasms / Q000175:diagnosis*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*