PMC5548420_01
Sagittal postcontrast (A) and axial precontrast (B) and postcontrast (C) T1-weighted MR images demonstrating a left-sided paraspinal mass infiltrating the spinal canal. Arrows indicate involvement of the left vertebral artery. Postoperative changes from a prior C6-7 ACDF are visible on the sagittal image.
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F1
Fibrosis and scattered lymphoid aggregates are observable (A). There are also focal areas of plasma cell clusters (B), some of which are positive for IgG4 (C). H & E (A and B), original magnification x4 (A) and x40 (B and C).
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F2
According to pathological analysis, the tissue had undergone dense fibrosis, and lymphoplasmacytic inflammation was noted, as was possible focal obliterative phlebitis (Fig. 2).
Sagittal (A) and axial (B) postcontrast T1-weighted MR images obtained at initial presentation (prior to initiation of treatment), and sagittal (C) and axial (D) postcontrast T1-weighted MR images obtained 2 weeks postinitiation of steroid treatment. The enhancing paraspinal mass infiltrating the spinal canal in the initial pretreatment images is seen to decrease in size in the posttreatment images.
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F3
An MRI study performed after 2 weeks of treatment showed that the mass had decreased in size (Fig. 3).
Sagittal postcontrast (A) and axial precontrast (B) and postcontrast (C) T1-weighted MR images obtained at the initial presentation (prior to initiation of treatment). Sagittal postcontrast (D) and axial precontrast (E) and postcontrast (F) T1-weighted MR images obtained 6 months after initiation of steroid therapy. The enhancing paraspinal and epidural mass seen in the initial images (A-C) shows stable improvement after 6 months of treatment (D-F). Arrows indicate involvement of the left vertebral artery.
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F4
Magnetic resonance imaging revealed stable resolution of the paraspinal mass (Fig. 4).