Systemic work-up failed to reveal malignancy, and there was a negative blood work-up for myeloma. 

A biopsy of the T7 vertebral body demonstrated bone with hypocellular marrow, scattered plasma cells, and reactive changes without evidence of myeloma, lymphoma, or carcinoma. 

In situ hybridisation for kappa and lambda light chains did not reveal clones.

After an extensive work-up, a final diagnosis of atypical haemangioma of the T7 vertebral body was provided. A follow-up chest radiograph was performed one year later and demonstrated the stability of the T7 and T5 vertebral body lesions.

Given the challenge of distinguishing metastatic disease from atypical vertebral haemangiomas in radiologic studies, some authors have proposed the use of advanced MRI imaging (T1 weighted dynamic contrast-enhanced MRI, among others) to distinguish atypical haemangiomas from vertebral metastatic disease.