Pneumatocyst, mimicking a sclerotic bony lesion on magnetic resonance imaging

Abstract

Background Context Intravertebral pneumatocyst is an uncommon benign lesion, not related to conditions, such as osteomyelitis and postsurgical state, with only a few cases reported in the literature. Purpose The purpose of the study was to report a case of cervical pneumatocyst resembling a sclerotic lesion on magnetic resonance imaging (MRI) and review of literature. Study Design/Setting The study was designed to be a case report. Patient Sample The patient chosen was a 48-year-old woman with the chief complaint of neck pain and bilateral upper extremity paresthesia of 6 months duration. Neurologic examination and results of routine hematologic and biochemical examination were normal. Results Cervical spine MRI revealed a low signal bony lesion on T1 and T2 images. Considering the signal characteristics, initial diagnosis of sclerosis was made. Reviewing the cervical X-ray, a round faint lytic lesion was detected. Correlation with cervical computed tomography scan showed the lesion being of air density, compatible with the diagnosis of pneumatocyst. Conclusion Intraosseous pneumatocyst of cervical spine is a benign finding, which needs no specific treatment; however, it must be included in the differential diagnosis of lucent vertebral lesions seen on conventional radiography and should be differentiated from bony neoplasm and osteomyelitis by its characteristic imaging findings.