Enlarging Vertebral Pneumatocysts in the Cervical Spine
=======================================================

* Gokhan Arslan
* Metin Cubuk

We read with interest the report by Kitagawa et al about enlarging vertebral pneumatocysts in the cervical spine (1). It would seem to have been appropriate for these authors to cite our earlier report about vertebral pneumatocysts (2), because it is the only report indicating the prevalence of vertebral pneumatocysts and contains the largest series of such patients. Without citing our report, the authors’ report seems to have some major handicaps. For example, including our patients, there are 22 cases of intravertebral pneumatocysts, instead of 12 cases. Also with reviewing features of our cases, authors could have given more appropriate documentation of reported cases in the English-language literature.

The authors cited the Hall and Turkel study, but they missed the fact that Hall and Turkel also mentioned subsequent enlargement of a pneumatocyst in the ilium by CT (3). So Kitagawa et al’s case is not the first enlarging pneumatocyst reported in the literature, but it is the first enlarging cervical vertebral one.

Also, writing and publishing scientific papers is facilitated by the wide accessibility of such electronic search tools as Pubmed and Medline, through which major journals are easily accessible. Statements carrying the disclaimer “to our knowledge,” in our opinion, should be used only when full and careful literature searches have been achieved. Nevertheless, we congratulate the authors on their well-written and superbly illustrated report.

## References

1.  Kitagawa T, Fujiwara A, Tamai K, et al. **Enlarging vertebral body pneumatocysts in the cervical spine.** AJNR Am J Neuroradiol 2003;24:1707–1710
    
    [Abstract/FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIyNC84LzE3MDciO3M6NDoiYXRvbSI7czoyMToiL2FqbnIvMjUvMTAvMTg2NS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  Arslan G, Ceken K, Cubuk M, et al. **Vertebral pneumatocysts.** Acta Radiol 2001;42:20–23
    
    [FREE Full Text](http://www.ajnr.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6MzoiUERGIjtzOjExOiJqb3VybmFsQ29kZSI7czo1OiJzcGFjciI7czo1OiJyZXNpZCI7czo3OiI0Mi8xLzIwIjtzOjQ6ImF0b20iO3M6MjE6Ii9ham5yLzI1LzEwLzE4NjUuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

3.  Hall EM, Turkel D. **Case report 526: intraosseous pneumatocyst of the ilium.** Skeletal Radiol 1988;18:127–128
    
    

#  {#article-title-2}

*Reply* 

We appreciate Drs. Arslan and Cubuk’s letter regarding inappropriate references in our report.

We also apologize to Dr. Arslan and colleagues for our not citing their previous comprehensive report regarding vertebral pneumatocysts.

As they noted, because multisection CT is widely used in clinical settings, we realize that vertebral pneumatocysts exist more frequently than previously reported, especially in severely degenerated spine. Nevertheless, the course of vertebral pneumatocysts is still unclear, as is their relationship to vertebral cystic lesions. We have still to follow the patients in our report and have observed other patients with pneumatocysts by using multisection CT. We hope we can report on this topic in the foreseeable future.

*   Copyright © American Society of Neuroradiology