A 70-year-old man comes to the office due to 3 weeks of unrelenting low back pain. He was grocery shopping when he first noticed the pain. The patient reports no trauma or leg weakness but describes having to strain to urinate. He has a history of hypertension and hyperlipidemia and has not seen a doctor in the past 5 years. His wife died a year ago, and he now lives alone. The patient is a retired construction worker and has a history of tobacco and marijuana use. There is tenderness in the lower vertebral area. Imaging study of the spine reveals several osteoblastic lesions in the lumbar vertebrae. Which of the following structures was most likely involved during the spread of this patient's disease? Azygos veins Internal iliac lymph nodes Pampiniform plexus Paraaortic lymph nodes Prostatic venous plexus Vertebral artery
A 70-year-old man comes to the office due to 3 weeks of unrelenting low back pain. He was grocery shopping when he first noticed the pain. The patient reports no trauma or leg weakness but describes having to strain to urinate. He has a history of hypertension and hyperlipidemia and has not seen a doctor in the past 5 years. His wife died a year ago, and he now lives alone. The patient is a retired construction worker and has a history of tobacco and marijuana use. There is tenderness in the lower vertebral area. Imaging study of the spine reveals several osteoblastic lesions in the lumbar vertebrae. Which of the following structures was most likely involved during the spread of this patient's disease?
- Azygos veins
- Internal iliac lymph nodes
- Pampiniform plexus
- Paraaortic lymph nodes
- Prostatic venous plexus
- Vertebral artery
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