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What Does 'extensive Heterogeneity Of The Marrow Of All Of The Visualized Vertebrae With Overall T1 Hypointensity' Mean?

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Posted on Sat, 8 Feb 2014
Question: I have been diagnosed with: Extensive heterogeneity of the marrow of all of the visualized vertebrae with overall T1 hypointensity, possibly secondary to red marrow reactivation/conversion. No focal enhancing lesion or soft tissue mass identified. What does this mean? I have MGUS and I am concerned.
doctor
Answered by Dr. Manjeth Kumar G (1 hour later)
Brief Answer: May be MGUS developing into Multiple Myeloma. Detailed Answer: Hello, I have gone through your query and understand your concern. Our Bone marrow is composed of yellow and red marrow. In the first two decades of life, our vertebral bone marrow mostly contains red marrow. As the age advances, the red marrow progressively decreases and yellow or fat marrow increases. The decline in red marrow is accompanied by an progressive increase in fatty marrow. But in your case, there is a Red marrow reactivation or Conversion. The yellow or fat marrow is reconverting into red marrow. Fatty marrow reconverts to red marrow where there is an increased demand for blood forming cells in bone marrow and the hematopoietic capacity of existing red marrow stores is exceeded. The most common cause of these reconversion is Severe Chronic Anemia and leukemia, lymphoma, multiple myeloma, and metastases.. Common metastatic site is vertebral bone marrow. As you have Monoclonal gammopathy of unknown significance, it may be turning into Multiple Myeloma. Around 1 in 100 people with MGUS can develop myeloma in future after diagnosis as MGUS. You may need further investigations like Blood and urine tests as well as bone marrow aspiration tests ( to identify the presence of plasma cells)to confirm whether it is due to Myeloma or other chronic anemic causes. Hope this helps. Please write back for further queries. Wishing you good health.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Manjeth Kumar G (52 minutes later)
I appreciate your XXXXXXX explanation. Extensive seems to refer to an advanced stage of accumulation of red blood cells? I am blessed to have good health insurance and will follow up promptly. Kind Regards
doctor
Answered by Dr. Manjeth Kumar G (14 hours later)
Brief Answer: No. Hematopoietic cells are rich in marrow. Detailed Answer: Hello, Thanks for your reply. No. In Red marrow conversion, there is increase in red marrow more than yellow marrow. As you think of, Red marrow does not contain Red blood cells. In fact there is increase in the Hematopoietic cells. Hematopoietic stem cells are the blood cells in marrow that give rise to all the other cells in the blood. They give rise to blood cells like monocytes and macrophages, neutrophils, basophils, eosinophils, erythrocytes( RED BLOOD CELLS), megakaryocytes/platelets, dendritic cells, T cells as Well as B cells. Thus red blood cell is the one of differentiating cell of Hematopoietic cells. As you have insurance, Please proceed to further investigations which i mentioned above and get proper treatment. Hope this helps. Please write back for further queries. Wishing you good health.
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Manjeth Kumar G

General & Family Physician

Practicing since :2010

Answered : 1120 Questions

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What Does 'extensive Heterogeneity Of The Marrow Of All Of The Visualized Vertebrae With Overall T1 Hypointensity' Mean?

Brief Answer: May be MGUS developing into Multiple Myeloma. Detailed Answer: Hello, I have gone through your query and understand your concern. Our Bone marrow is composed of yellow and red marrow. In the first two decades of life, our vertebral bone marrow mostly contains red marrow. As the age advances, the red marrow progressively decreases and yellow or fat marrow increases. The decline in red marrow is accompanied by an progressive increase in fatty marrow. But in your case, there is a Red marrow reactivation or Conversion. The yellow or fat marrow is reconverting into red marrow. Fatty marrow reconverts to red marrow where there is an increased demand for blood forming cells in bone marrow and the hematopoietic capacity of existing red marrow stores is exceeded. The most common cause of these reconversion is Severe Chronic Anemia and leukemia, lymphoma, multiple myeloma, and metastases.. Common metastatic site is vertebral bone marrow. As you have Monoclonal gammopathy of unknown significance, it may be turning into Multiple Myeloma. Around 1 in 100 people with MGUS can develop myeloma in future after diagnosis as MGUS. You may need further investigations like Blood and urine tests as well as bone marrow aspiration tests ( to identify the presence of plasma cells)to confirm whether it is due to Myeloma or other chronic anemic causes. Hope this helps. Please write back for further queries. Wishing you good health.