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SCHMORL HERNIA ON L3 VERTEBRA in MRI after fall.

Resolved Question:

Hello,
I am 33, male, 6'1" tall and 176lbs, caucasian race, Italian, and I am looking for a diagnosis. First off, sorry for any incorrect English, I am not a native speaker.

Nov 2013 - While playing in the waves I tumbled and crashed into the sand arching my back violently. Since then I've been suffering some pain on the lower back and between the shoulders.

Mar 2014 - MRI shows a Schmorl hernia on the L3 vertebrate, but also suspicious "stains" all over the spine. (dark spots)

Jun 2014 - CAT scan confirms the hernia and the stains on the spine and left iliac crest.

Jul 2014 - PET scan confirms the stains on the spine and left iliac crest, concentrated mostly on the L3 vertebrae.

Jul 2014 - Bone scintigraphy confirms the stains as above.

Jul 2014 - Blood tests as uploaded

Jul 2014 - Bone biopsy on L3 and iliac crest. The pathologic analysis shows a proliferation of lymphocytes cells, B and T types, polyclonal. No possible diagnosis but 2 hypotheses: either an infection or the birth of a lymphoma.

Sep 2014 - 2nd bone biopsy on L3, L5, S1, and iliac crest. The pathologic analysis says the same as the previous biopsy.

Oct 27th 2014 - More blood and urine exams as uploaded

A new biopsy is scheduled for March 2015.

In the meantime I have never had any fever, diarreha, vomit. I have a healthy appetite. I go to the bathroom with no problems. I also workout once per week, and have pretty good energy in general. I only have the same back pain since the Nov 2013 accident, and stomach pain occasionally. (might be acid reflux)

The oncologist says that he doesn't have a diagnosis for me, and that is not a cancer but since the PET scan shows stains, it has to be something.

I am concerned, and especially I don't want to take another biopsy.

Do you have any opinions about this complicated case? Thank you, I really appreciate any insight.


Category: Hematologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
The report does not really reveal much since there are couple of probabilities.
The present available report does not lead towards a possible diagnosis. A repeat biopsy of the lesion and bone marrow / peripheral blood smear analysis with complete IHC study can contribute to diagnosis.
The main dilemma is about not missing a malignancy at this stage. Other conditions are treatable.
Kindly proceed with another biopsy procedure.
Wishing you a speedy recovery.
Regards.


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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