PMC9560686_01
Pre- and postoperative spine MRI. Pre- (A) and postoperative (B) T2-weighted sagittal (upper) and axial (lower row) MRI series. Asterix (sagittal) and arrowhead (axial section) shows the site of the spinal cord compression.
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A magnetic resonance imaging (MRI) of the spinal cord showed an anterior displacement of the spinal cord with posterior intradural septation and focal spinal cord compression at the level of Th2 (see Fig. 1A). At this level, the dorsal caudal arachnoid space was widened showing a so-called "scalpel sign", suggesting the presence of a spinal arachnoid web (see Fig. 1A). Next, the dural sac was opened to expose the lesion (see Fig. 2 and Additional file 1). Postoperative imaging revealed complete resection of the lesion with a decompressed spinal cord and a now better delineable slight myelopathy signal (see Fig. 1B).
Intraoperative view. Intraoperative, intradural view before (A) and after (B) resection of the amyloid deposits. After dural opening: (A) shows the glossy white colored amyloid deposit. (B) spinal cord with peri-medullary vessels come into view after complete resection of the lesion.
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Next, the dural sac was opened to expose the lesion (see Fig. 2 and Additional file 1).
Histopathological specimen Histological specimen: The biopsy showed scattered connective tissue and predominantly amorphous material. The latter corresponded to amyloid under polarizing light (green) with Kongo Red staining. Scale bar corresponds to 100mum. . (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)
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The histopathological examination described multiple large-scale congophilic amyloid deposits within the amorphous material (see Fig. 3).