A large destructive complex cystic and solid left paraspinal soft tissue lesion is seen centered on and destructing the posterior portion of the left 5th and 6th ribs as well as the adjoining parts of the related vertebral bodies, measuring about 6 x 7 cm along its axial dimensions respectively, showing cystic components of high T1 signal (high protein content), showing heterogenous intense post-contrast enhancement. The mentioned left paravertebral disease process is seen having an intra-thoracic extra-pulmonary component attaining a left paravertebral / posterior mediastinal location. It is seen extending through the left D4-5 down to D6-7 neural foramina having an intraspinal extradural component compressing the dorsal spinal cord, it is seen also infiltrating the left paraspinal muscles at that level with associated small subcutaneous cystic component. abnormal bone marrow signal pattern of the related D4 down to D6 vertebral bodies (edema pattern).
other similar yet smaller destructive osseous lesions are seen involving the heads of left 10th and 12th ribs with similar associated neural compromise, with associated similar abnormal signal of the related vertebral bodies.
An ill defined heterogeneously enhancing right paraspinal lesion is seen encroaching on the apical and medial basal segments of the right lower lung lobe, measuring about 5.5x4.5x7.5 cm along its AP, TS and CC dimensions respectively, with surrounding area of consolidation.