Question
QUESTION: Hi Jerry,

It is me Dena Cline again.  I sent you a copy of some MRI reports from July 2006, but I just reiceved July 2007 reports and wanted to send a copy to you.  

My biggest concern is the issue listed about the 5mm lesion.  I am not really sure what a lesion is and if this something I need to ask my surgeon to further evaluate?  

This report is telling me it is more than likely benign, but that to me does not tell me that they are 100% sure it is benign, so I am wondering it further tests on it should be looked into?

Have a nice weekend...

Thanks,
Dena Cline

===========================================================Here is a copy of the latest reports I got from my most recent MRI study done on 7/17/07.

Findings:

Mild motion degradation.  There has been previous T8-T9 posterior spinal fixation with artifact related to bilateral transpedicular screws at these two levels.  The cervical, thoracic, and lumbar vertebral bodies maintain normal height, and alignment.  There is a nonspecific, subtle, 5mm, T1 hypointense and T2 hyperintense, enhancing lesion in the right posterior T6 vertebral body.  There is a small hemangioma of the left T11 vertebral body.  The remaining vertebral bodies maintain normal marrow signal.

Moderate degenerative disc disease is present between T5-6 and T11-12.  There is also moderate L5-S1 degenerative disc disease.  Minimal posterior disc bulging or disc protrusions are present at C2-3, C3-4, C5-6, C6-7.  Small posterior disc protrusions or disc osteophyte complexes are present at T6-7, T8-9, and T10-11.  There is associated mild to moderate T8-9 spinal stenosis.  There is a small central disc protrusion at L5-S1.

Impressions:

Previous bilateral T8-9 posterior spinal fixation with residual small left paramedian disc protrusion and mild to moderate spinal stenosis.

Moderate degenerative disc disease present in the mid to lower thoracic spine without additional areas of spinal stenosis.

Non specific, subtle, 5mm focus of T2 hyperintensity and enhancement in the right T6 vertebral body.  This appears to correspond to a subtle, rounded, peripherally sclerotic lesion seen on a previous MRI, and is likely benign.  However, comparison with previous outside studies is recommended to confirm long-term stability.


ANSWER: A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. The term 'benign' indicates that it may be cancerous so I recommend asking your neurosurgeon more questions about the lesion.  

Thank you for your follow-up question, Dena.  I hope that my answer was helpful.

---------- FOLLOW-UP ----------

QUESTION: Jerry thank you for clarifying for me what a lesion is.  I have a few more follow up questions for you.  Hope you don't mind.  So far you have given me the most and best information from this web site.  You are definitely an asset to this site.  Thanks again.

1.  When you say a lesion can be caused by a disease, would degenerative disc disease be qualified for that?

2.  When you say the lesion can be caused by trauma.  Could that be considered from a fall?  Back in May 2007 I fell and broke my left foot, when I fell I fell flat on my back.

3.  Is a lesion basically like a small tumor?  My lesion is 5mm which is equal to 2 inches, is that fairly big to be on the spine area.

Thanks for all your help Jerry, this is all very new to me and a little concerning to me as well.  I see my Orthopedic surgeon in 1 week, and I will be bringing up  the issue and demanding that further tests be done to make sure it is not cancerous. I would rather have a few tests done now, than be sorry later if it is cancerous.

The MRI report even tells which numbered picture to look at to see the lesion.  So I will take the CD-Rom with me so that the surgeon can look at it.

My biggest concern right now is that the MRI states that the lesion is on the right side, and I have excruciating pain on my right side of my back, and several other symptoms on my right side of my back that have occurred since my fall in May of 2007

Thanks again I appreciate your time and knowledge.

Blessings,
Dena Cline

Answer
Degenerative disc disease isn't one of the condition that typically causes lesions.  It usually is something like multiple sclerosis or cancer.

Trauma, such as the fall you've described, can cause lesions.

A lesion can be a tumor but not necessarily so.  It can also be a hole in the protective tissue which is the case in multiple sclerosis.

Your surgeon will be able to give your a much more complete answer since he/she will have access to the MRI itself.

Thank you for your follow-up question, Dena.  I hope that my answer was helpful.