PMC4743271_01
Magnetic resonance images of the cervical spine demonstrating a well-defined oval intramedullary lesion expanding the spinal cord at C7-Th1. (a) Sagittal T2-weighted-images demonstrating a well-defined hypointense mass causing an important edema above and under it. (b) Homogenous gadolinium enhancement is evident. (c) A predominant anterior location within the spinal cord is observed on axial images after the application of gadolinium
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F1
Magnetic resonance images (MRIs) of the cervical spine [Figure 1], demonstrated a well-defined oval intramedullary lesion expanding the spinal cord at the C7-Th1 level, with a clear hypointense signal on T2-weighted images, and showed homogeneous enhancement after gadolinium application, suggesting an intramedullary solid, and well-defined tumor.
(a) Histopathology: Proliferation of large foamy histiocytes with abundant cytoplasm accompanied by plasma cells, lymphocytes, polymorphonuclear cells and eosinophils (H and E, x10). (b) Intact inflammatory cells inside the cytoplasm of some histiocytes (emperipolesis)
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F2
The histology of the lesion [Figure 2], characterized an important proliferation of large histiocytes with foamy cytoplasm, pale irregular nucleus and small vesicular nuclei, some of them with the appearance of engulfed intact lymphocites.
(a) Immunohistochemistry: Double immunohistochemical staining revealing histiocytes enhanced by CD68 (brown). Lymphocytes enhanced by CD45 antibodies (in red) confirming emperipolesis. (b) CD68 immunohistochemical staining enhancing the histiocyte population
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F3
The immunohistochemistry confirmation [Figure 3] reported mature lymphocytes that were positive to CD45/CD68 antibodies and positive CD20 and CD3 in mature B lymphocytes that were within larger histiocytes (emperipolesis); positive CD60 in histiocytes; positive CD30 in immuneblasts; positive CD15 in leucocytes and negative to the latent membrane protein-1 antibody.