PMC8175162_01
A lumbar spine MRI sagittal ((a) T1, (b) T2, and (c) T1 with contrast).
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This lesion was heterogeneously enhancing after injection of contrast (Figures 1 and 2).
A lumbar spine MRI axial view ((a) T2 and (b) T1 with contrast).
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fig2
This lesion was heterogeneously enhancing after injection of contrast (Figures 1 and 2).
A lumbar spine CT scan: axial and sagittal views.
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fig3
A posterior extension was noted mainly at the L3 level (Figure 3).
X-ray AP view and intraoperative image post-intrapedicular screw insertion and laminectomy.
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fig4
Using a posterior midline approach, a laminectomy from the lower edge of L1 to L3 was performed with fixation on T12, L1, and L4 on both sides (Figure 4).
Intraoperative images for spinal tumor resection.
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fig5
The dura was opened proximal and distal to the lesion, and it was noted that the nerve roots were scattered over the tumor surface and invading the tumor (Figures 5(a) and 5(b)). Almost a complete tumor resection was achieved under an operating microscope by CUSA (Figure 5(c)).
(a) Clear cell meningioma exhibiting sheets of round to polygonal cells arranged in a haphazard manner alternating with areas with thick bulky interstitial collagenization (H&E, 100x). (b) High magnification image shows lesional cells with clear cytoplasm (H&E, 400x). (c) The cytoplasm contains glycogen demonstrated by periodic acid-Schiff (PAS; 400x). (d) Weak membranous immunoreactivity for epithelial membrane antigen (IHC, 400x).
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In addition, there are areas showing angiomatous-like features (Figures 6(a) and 6(b)). The cells demonstrated periodic acid-Schiff-positive, diastase-sensitive intracytoplasmic glycogen granules (Figure 6(c)).