PMC7771492_01
(a) T2 sagittal MRI cervical spine showing complete destruction C4 with partial destruction of C3 and C5 body with anterior epidural collection with compression of cervical spinal cord between C3 and C5. (b) T1 gadolinium contrast-enhanced sagittal MRI cervical spine showing contrast-enhanced epidural lesion anterior to C3-C5. (c) Axial contrast-enhanced cervical MRI at C4 showing canal compromise. (d) Postoperative NCCT cervical spine shows adequate decompression between C3 and C5 with expandable titanium cage in situ.
SNI-11-373-g001.jpg
PMC7771492_01_SNI-11-373-g001.jpg
F1
When these studies confirmed a destructive C3-5 lesion with an epidural collection, unchanged from prior study, the patient underwent an anterior C3, C4 (complete), and C5 (partial) corpectomy/fusion using an expandable cage [Figure 1a-d].
Photomicrographs showing (a) large atypical cells scattered around and at places focally aggregated; the atypical cells have abundant cytoplasm, wreath-like nuclei, embryo-shaped nuclei with open chromatin and multiple nucleoli; background shows mixed lymphoid population and eosinophils (H&E, x400). Immunohistochemistry showing (b and c) diffuse, strong positivity for CD4 and CD30, respectively, in the atypical cells, and (d) diffuse positivity of LCA in large atypical cells.
SNI-11-373-g002.jpg
PMC7771492_01_SNI-11-373-g002.jpg
F2
Negative anaplastic lymphoma kinase-1 staining in the atypical cells (Immunoperoxidase, x400).
SNI-11-373-g003.jpg
PMC7771492_01_SNI-11-373-g003.jpg
F3