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SCHMORL HERNIA ON L3 VERTEBRA in MRI after fall.

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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
 24 Doctors Online

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.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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