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An ill defined heterogeneously enhancing right paraspinal lesion is seen encroaching on the apical and medial basal segments of the right lower lung lobe, measuring about 5.5 x 4.7 x 7.7 cm along its AP, TS and CC dimensions respectively, with surrounding area of consolidation, showing air bronchogram within. The mentioned lesion is seen reaching to the right lower lobe segmental bronchi as well as the related vessels, and abutting the right main bronchus and pulmonary vessels as well as the azygos vein. Few surrounding nodular densities are seen involving the right lower lobe, as well as the posterior segment of the right upper lobe some of them are pleural based, largest measures about 2.2 cm. The described right lower lobe paravertebral lesion is seen inseparable from multiple enlarged right hilar and subcarinal mediastinal lymph nodes with other discrete retrocaval lymph node is seen measuring about 1.3 x 1 cm. mild left basal pleural thickening / effusion is noted with few related basal pulmonary atelectatic bands.
A large destructive left parspinal soft tissue lesion is seen centered on and destructing the posterior portion of 5th and 6th ribs as well as the adjoining parts of the related vertebral bodies, measuring about 6x5.8x7.2 cm along its TS, AP and CC dimensions respectively, seen having an intra-thoracic extra-pulmonary component attaining a left paravertebral / posterior mediastinal location, it is seen extending through the left D4-5 down to D6-7 neural foramina having an intraspinal extradural component compressing the dorsal spinal cord, it is seen also infiltrating the left paraspinal muscles at that level with associated small subcutaneous cystic component.
Other similar yet smaller destructive osseous lesions are seen involving the heads of left 10th and 12th ribs with similar associated neural compromise.
Minimal pericardial effusion is noted.
Left iliac laterally located subcutaneous cystic lesion is seen.