Can You Please Explain This To Me Because I'm Super Stressed?

Posted on Wed, 11 Nov 2020

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 11 Nov 2020 Answered on

Wed, 30 Apr 2025 Last reviewed on

Question : I received an mri of the lumbar and brain recently for symptoms of being light headed and headaches on and off cat scan was normal so further looked into it with the mri of the brain, and mri of my lumbar because of back pain and was a lil sensitivity to my nereves in my legs but the legs I only felt that once but he wanted to cover all areas. My concern when I received my report today was it says a diffuse heterogeneous abnormal marrow signal and visualized lower thoracic,lumbar and sacral spine. MALIGNANCY NOT EXCLUDED. Recommend bone scan to further evaluate. Abnormal through out with scattered area of T1 hypointensity and STIR hyperintensity. I am super nervous scared especially hearing malignancy not excluded can you please explain this to me because I'm super stressed. Also on my mri of the brain only concern with that it says possible left parotid nodule 11mm left side and the nurse wants me to see an ENT specialist to evaluate that. Please help me and explain to me.

Answered by Dr. Dr. Erion Spaho (9 hours later)

Brief Answer:
Further examinations are necessary for a correct diagnosis.

Detailed Answer:
Hello,

Diffusely heterogeneous abnormal marrow signal may represent the patchy conversion of red to yellow marrow that is a normal variant seen in older adults.

However, since the MRI states that malignancy could not be excluded, other tests are necessary to exclude metastatic disease, infectious processes, hematological malignancy such as multiple myeloma, etc.

Besides bone scan, bone marrow biopsy (myelogram) is necessary for a correct diagnosis.

The parotid nodule seems to be not a problem since it is solitary and there are no characteristics in the MRI for malignancy.

Discuss with your Doctor these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Erion Spaho (2 hours later)

So as far as the diffuse heterogeneous abnormal marrow is that common alot of the times especially me being 39 I know u said in older adults. Basically just askimg is that common alot on mri there just not excluding malignancy because its other test that looks deeper into the marrow before they just clear you saying everything is good. My nerves are up hearing the malignancy is not excluded stuff thats all. So its not sayimg they see malignancy are anything just doing other test before they just say its all clear as of the malignancy is that correct

Answered by Dr. Dr. Erion Spaho (4 hours later)

Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

In a number of people, especially without any clinical symptoms to support malignancy, these MRI findings may not indicate any pathological process.

To be sure entirely, proper tests should be performed.

Besides malignant processes, these MRI findings may be present in infections that involved the bone marrow too.

Hope this helps.

Take care.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Erion Spaho (2 days later)

So with what I explained what all was said on the report I forgot it also said my mri showed scattered areas of t1 hypointensity and stir hyperintensity is that saying that its cancer showing with them saying the diffuse heterogeneous abnormal marrow

Answered by Dr. Dr. Erion Spaho (7 hours later)

Brief Answer:
Explained below.

Detailed Answer:
Welcome back.

The STIR hyperintensities in the brain may be of inflammatory origin, but also may be linked to the neoplasms also.

This should be evaluated by further testing
as we discussed before.

Hope this helps.

Greetings.

Above answer was peer-reviewed by : Dr. Vaishalee Punj