PMC5154198_01
(a) MRI spine sagittal cut T2 weighted showing hyperintense anteriorly placed paraspinal lesion extending from D11 to lower border of D12; (b) MRI spine axial cut post-contrast homogenous enhancement and close proximity with inferior vena cava (IVC); (c) MRI spine coronal cut showing lesion measuring 46.0 x 36 mm closely abutting the abdominal aorta and is displacing the IVC anteriorly
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F1
Magnetic resonance imaging of the abdomen including thoracolumbar spine with and without intravenous contrast [Figure 1] showed a retroperitoneal paraspinal mass measuring 46.0 x 36 mm right crus of the diaphragm anterolateral to T11-T12 vertebral bodies reaching up to T12-L1 intervertebral disc.
Well-circumscribed, encapsulated nodular tissue measuring 5.5 x 4.5 x 3.5 cm
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F2
The examination of gross surgical specimen [Figure 2] revealed a well-circumscribed, encapsulated nodular tissue measuring 5.5 x 4.5 x 3.5 cm.
(a) Hematoxylin and eosin stained section (Original magnification x10) showing well-defined nests of cuboidal cells having granular cytoplasm, separated by highly vascular septae. (b) tumor cells show cytoplasmic staining for Immunohistochemical stain synaptophysin (Original magnification x20); (c) immunohistochemical stain chromogranin, positive in cytoplasm of tumor cells. (Original magnification x20); (d) Immunohistochemical stain S-100. (Original magnification x20)
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F3
Microscopic examination [Figure 3] revealed well-defined nests of cuboidal cells arranged in a "Zellballen" pattern which were separated by highly vascular fibrous septae.