PMC5241451_01
Preoperative MRI showed an epidural mass extending from the fifth to the tenth thoracic vertebra canal. (a) Sagittal plane. (b) Axial plane (Th7).
CRIOR2017-2416365.001.jpg
PMC5241451_01_CRIOR2017-2416365.001.jpg
fig1
MRI of the thoracic spine showed an epidural mass extending from the fifth to the tenth thoracic vertebra (Figure 1).
Photograph of the thoracic epidural mass. (a) The dorsal epidural mass is continuous from the fifth to the tenth thoracic vertebra canal after laminectomy. (b) The thoracic epidural mass specimen is reddish brown and hematoma like in appearance.
CRIOR2017-2416365.002.jpg
PMC5241451_01_CRIOR2017-2416365.002.jpg
fig2
The laminal arch of vertebrae from the fourth to the ninth thoracic spine was removed, and the reddish brown continuous mass was excised (Figure 2).
Histology of the epidural mass. Hematoxylin and eosin staining. Arrows suggest hematopoietic cells. Black, megakaryocytic; red, erythropoietic; yellow, myelopoietic. Magnification x40.
CRIOR2017-2416365.003.jpg
PMC5241451_01_CRIOR2017-2416365.003.jpg
fig3
Histological examination confirmed the diagnosis of EMH because of the presence of hematopoietic cells differentiated into mature myelopoietic, erythropoietic, and megakaryocytic cells (Figure 3).
Immunohistochemistry of the epidural mass. High expression of cell surface markers for erythroblasts (glycophorin A), megakaryocytes (CD41), and granulocytes (MPO) was observed. Magnification x40.
CRIOR2017-2416365.004.jpg
PMC5241451_01_CRIOR2017-2416365.004.jpg
fig4
Furthermore, immunohistochemical analysis of surgical sample was performed by using glycophorin A (DAKO, clone: JC159, 1 : 400) for erythroblasts, CD41 (Calbiochem, clone: 283.16B7, 1 : 2000) for megakaryocytes, and MPO (DAKO, rabbit polyclonal, 1 : 500) for granulocytes (Figure 4).
MRI taken one year later shows no recurrence. (a) Sagittal plane. (b) Axial plane.
CRIOR2017-2416365.005.jpg
PMC5241451_01_CRIOR2017-2416365.005.jpg
fig5
A year after the surgery, there were no clinical or radiological signs of recurrence (Figure 5).