PMC9479634_01
(a) STIR magnetic resonance imaging (MRI) parasagittal view of the cervical spine. (b) STIR MRI mid-sagittal view of thoracic spine. (c) MRI STIR mid-sagittal view of lumbar/sacral spine. (a-c) shows multiple mildly enhancing spinal lesions with very high T2 signal best seen on STIR (yellow arrows) at C2-3, C3-4, C5-6, T2-3, T3-4, T8-9, S2-3, and S4 levels. These lesions have variable bone and soft tissue involvement. (d) T2 axial image of the dominant lesion at T8-9 level, showing a lobulated T2-hyperintense lesion with well-defined margins involving bone (green arrow) with paraspinal (red arrow) and epidural (blue arrow) extension.
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F1
CT and magnetic resonance imaging (MRI) scans of the entire neuroaxis were performed showing multiple lesions involving the cervical/thoracic spine, sacrum, and left parietal scalp/ bone, Figure 1.
(a and b) H&E sections from T8-9 vertebral body mass demonstrating enlarged multivacuolated and physaliphorous cells with round to ovoid nuclei. Immunohistochemical staining demonstrates strong nuclear positivity for brachyury (c) and strong cytoplasmic staining for AE 1/3 (d) These pathologic findings are classic for chordoma.
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F2
The specimen contained nests and lobules of cells with rounded nuclei and abundant eosinophilic vacuolated cytoplasm focally, with myxoid material seen in the background, [Figure 2]. Figure 3 shows a comparison of T2 axial slices, through the dominant lesion at T8-9 level, showing no change of the area encroaching around the spinal cord.
Axial T2 magnetic resonance imaging of the predominant lesion at T8-9. (a) Is from September 2018 outside films, (b) Is from November 2020. The area encroaching around the spinal cord has not changed.
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F3
Figure 3 shows a comparison of T2 axial slices, through the dominant lesion at T8-9 level, showing no change of the area encroaching around the spinal cord.