PMC2688648_01
CT image shows a well-circumscribed, minimally expansile lytic lesion in the right pedicle and adjacent transverse process of L5. Tiny densities (arrow) represented bony fragments from adjacent degenerated facet joint.
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fig1
Imaging evaluation including plain films, CT, and MRI showed a lytic, minimally expansile intraosseous soft-tissue mass occupying the right L5 pedicle and extending into the adjacent transverse process (Figure 1).
Fat-saturated T1 post-Gadolinium images show mixed intermediate signal in the lesion with moderate heterogeneous generalized enhancement. There is no adjacent edema or reaction in the bone or soft tissues. Small areas of low signal (arrows) are present.
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fig2
T2 and T1 weighted images with scattered areas of low signal intensity on both sequences, and diffuse minimally heterogeneous enhancement following intravenous Gadolinium (Figure 2). There was degenerative change in the adjacent facet joint.
Full length Tru-cut biopsy of the tumor. Note the entrapment of the skeletal muscle and adipose tissue at the periphery (double arrow) and involvement of the bone at the other end (single arrow). (H&E, 40X).
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Histology revealed a uniformly paucicellular tumor (Figure 3).
Hypocellular densely collagenous stroma of the tumor. (H&E, 400X).
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fig4
There were widely spaced, bland spindle to stellate shaped cells embedded in a dense fibrous stroma with homogeneous collagen bundles (Figure 4).