PMC6001686_01
MRI findings of the patient.
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(A) MRI midsagittal T1-weighted image of the cervicomedullary junction and thoracic spine showing a hypointense long segment with expansile mass with a maximal diameter of 1.7 cm measured at the lower cervical region. (B) MRI with intense enhancement after administration of gadolinium. (C) T2-weighted image showing the intramedullary mass with slight heterogenous signal intensity from the level of the medulla down to the (D) axial cut section of the conus medullaris.
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Initial work-up included a cranio-spinal magnetic resonance imaging (MRI) revealing a long expansile contrast-enhancing mass involving the entire spinal cord, from the level of the cervical region to the conus medullaris with extension to the lower medulla oblongata (Figure 1A-D).
Autopsy findings of the patient.
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(A) The right lung weighs 750 g and (B) the left lung weighs 450 g in situ, both lungs are red to maroon in color, all lobes are consolidated. (C) The spinal cord is 32 cm in length with cream-white smooth outer surface. (D) Cut section showing that the entire spinal cord was swollen and replaced by the mucoid, gelatinous material. (E) Photomicrograph of the tumor showing small, round cells, with slightly ovoid nuclei, occasional clumping of chromatin, cytoplasmic fibrillary process, perinuclear cytoptoplasmic clearing and vacuolation, small capillaries coursing through the tumor at low power field (10x magnification). (F) Photomicrograph at high power field (40x magnification).
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On autopsy, all lobes of the lungs were consolidated secondary to pneumonia (Figure 2A & B). There was swelling of the entire spinal cord with white to yellow mucoid material coming out from the central canal (Figure 2C). Cut sections showed that the entire spinal cord and caudal medullary region were replaced by mucoid material (Figure 2D). Fibrillary processes were noted in the cytoplasm (Figure 2E & F).