PMC4862298_01
(a) Saggital magnetic resonance imaging image showing T2-weighted hyperintense signals in spinal cord below D7 vertebral level; (b) axial images hyperintense signals in central spinal cord at D7-8 level (white arrows)
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F1
T1-weighted isointense and T2-weighted hyperintense signal abnormality from D7 to conus medullaris without cord expansion suggestive of granulomatous myelitis [Figure 1]. There was a marked postgadolinium enhancement on cord surface, extramedullary epidural and subdural abscesses along the cervical and dorsal cord, abnormal clumping, and contrast enhancement of cauda equina roots [Figure 2].
(a) Postgadolinium saggital magnetic resonance imaging images showing epidural and subdural fluid collections suggestive of abscesses and marked enhancement of cord surface from D7 to conus medullaris; (b) abnormal clumping and contrast enhancement of cauda equina roots on postgadolinium magnetic resonance imaging (white arrows)
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F2
T1-weighted isointense and T2-weighted hyperintense signal abnormality from D7 to conus medullaris without cord expansion suggestive of granulomatous myelitis [Figure 1]. There was a marked postgadolinium enhancement on cord surface, extramedullary epidural and subdural abscesses along the cervical and dorsal cord, abnormal clumping, and contrast enhancement of cauda equina roots [Figure 2].
X-ray chest postero-anterior view showing no evidence of tuberculosis
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F3
His chest X-ray (CXR) was normal [Figure 3], and sputum was negative for acid-fast Bacilli.
(a and b) Computed tomography chest axial and coronal images showing tuberculous lesions
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F4
Chest and abdomen computed tomography (CT) showed three soft tissue nodules in the right upper lobe, one in the right lower lobe and multiple peribronchial nodules, some with central cavitation and a 3 cm x 3.5 cm necrotic subcarinal lymph node [Figure 4].