PMC9610685_01
Intradural and leptomeningeal enhancement medullaris, sagittal T1 fat suppressed with contrast.
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F1
T1 contrasted images [Figures 1 and 2].
Enhancing nerve roots of the cauda equina, axial T1 with contrast.
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F2
T1 contrasted images [Figures 1 and 2].
Thickening and enhancement at the lower lumbosacral spinal canal (from approximately L4 to L5 through the S2 levels), sagittal T2.
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F3
The dura appeared thickened and avidly enhanced from L5 to S2 and there was a fluid-fluid level appreciated on the T2-weighted sequences suggesting possibly proteinaceous debris, blood, or pus [Figure 3]. The DWI image showed marked restriction from L4 to L5 through the S2 levels [Figure 4].
Soft-tissue collection demonstrating diffuse heterogeneous enhancement and marked restriction within the thecal sac, isotropic (diffusion-weighted imaging).
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F4
The dura appeared thickened and avidly enhanced from L5 to S2 and there was a fluid-fluid level appreciated on the T2-weighted sequences suggesting possibly proteinaceous debris, blood, or pus [Figure 3]. The DWI image showed marked restriction from L4 to L5 through the S2 levels [Figure 4].
Gomori methenamine silver stain showing hyphal forms, original magnification x400.
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F5
The histology showed rare nonseptate pseudohyphae and blastospores without a broad-based bud, indicative of a Candida species [Figure 5].
Hematoxylin and eosin stain showing necrosis, original magnification x400.
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F6
The submitted tissue was necrotic and demonstrated local inflammation on pathologic examination [Figure 6].