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There is marked osteolysis and destruction of C5 vertebral body, which is pathologically partially collapsed. Anterior cortex of C4, C6 and C7 vertebral bodies are eroded. There is ventral epidural extension posterior to C5 vertebral body, indenting the thecal sac with mild spinal narrowing. There is large prevertebral soft tissue mass infiltrating the longus colli muscles with central hypodensity extends from C2 to T1.
Cervical spine posterior elements are intact. Gross destruction of the posterior elements of T4 and T5 vertebrae which are only partially imaged. There is extra-osseous soft tissue extension into the spinal canal with moderate compression of the thecal sac at T4/T5 level.
Multiple soft tissue masses (presumed lymphadenopathy) within the anterior mediastinum with gross bony destruction of the manubrium.