PMC4508733_01
a: Sagittal lumbar spine, T1- weighted: well-defined, high signal lesion, located into the spinal canal behind L4 vertebral body. b: Coronar lumbar spine, T2-weighted: well-circumscribed, mixed-signal, intradural lesion, located between cauda equine nerve roots. c: Axial lumbar spine, T2-weighted: welldefined, intradural, round, occupying the spinal canal almost completely. d: Intraoperative view: well circumscribed tumor located between cauda equina nerve roots (black arrows). e: Irregularly dilated and packed vascular spaces separated by connective tissue walls, thickened by fibrosis (black arrowheads) and housing in many places a visible inflammatory cell population. f: Enlarged vascular spaces by the rupture of the thin connective tissue walls, with intratumoral hemorrhage and clot tendency (black arrows).
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F1
Lumbar computed tomography (CT) scan disclosed a spontaneous hyperdense area, located at L4, apparently intradural. Lumbar MRI examination revealed a well-defined lesion situated in cauda equina with high signal in T2-weighted images and discrete peripheral deposits of hemosiderin (Fig. 1a-c). After median opening of dura mater, a 1.5 cm in diameter, purple-reddish, mulberry-like, well-circumscribed lesion was found, growing between cauda equina nerve roots at L4 level (Fig. 1d). Inflammatory cells could be observed, scattered throughout the stroma (Fig. 1e). In some tumoral areas, the walls laceration resulted in the formation of cystic spaces, which determined intratumoral hemorrhage with the tendency to form clots (Fig. 1f).