Miniature brain in spine: the 'mini brain sign in vertebral plasmacytoma

Case history A 55-year-old male patient presented with backache for 1 month. There was no history of trauma. Haematological evaluation revealed an elevated erythrocyte sedimentation rate. Radiographic examination showed partial collapse of D12 vertebra with suspicious lytic lesion. MRI showed well-defined lytic lesion in D12 vertebral body appearing mildly hypointense on T1-weighted (T1W) images and mildly hyperintense on T2-weighted (T2W) images, with associated radially arranged thickened cortical struts appearing hypointense on T1W/T2W images, mimicking cortical sulci in brain (figure 1). A similar imaging appearance was seen on CT scan (figure 2). Based on the characteristic imaging findings, a provisional diagnosis of vertebral plasmacytoma was made. The diagnosis was confirmed on subsequent biopsy. Figure 1Axial T1W (A) and T2W (B) images showing vertebral lytic lesion with thickening of radially oriented cortical struts (white arrows) reminiscent of cortical sulci (‘mini brain’ appearance). ...
Source: Postgraduate Medical Journal - Category: Journals (General) Authors: Tags: Journalology, Pain (neurology), Breast cancer, Screening (oncology), Radiology, Surgical diagnostic tests, General surgery, Radiology (diagnostics), Ethics Images in medicine Source Type: research