PMC6699147_01
Epidural soft tissue mass located in the spinal canal outside the back of the dura mater at T4-T9 level, dura mater and spinal cord significantly compressed forward, and the narrowed spinal canal. (A) T1WI at the position of sagittalia, low signal, (B) Sagittal postcontrast T1-weighted image of the thoracic spine reveals enhancing sheet-like lesion in the posterior epidural region compressing the thoracic cord. Shown by red arrow mark, (C) T2WI at the position of sagittalia, high signal, (D) T2WI at coronal section, high signal, (E) T1WI contrast enhancing at transverse section, high signal at T7 level obviously enhanced, (F) T2WI at transverse section, high signal at T7 level. No abnormal changes were observed in the intervertebral disc.
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T7. T-SPOT.TB was positive. The enhanced magnetic resonance imaging (MRI) of thoracic vertebra on December 24, 2015 (Figure 1), suggested that thoracic 7 vertebral body, the thoracic 7 and 8 vertebral body accessory tuberculosis was considered, accompanied by intraspinal abscess formation.
(A) Hematoxylin and eosin stain (x40), (B) CD20 (+) (x20), (C) CD10 (+) (x20), (D) BCL-2 (+) (x20), (E) BCL-6 (+) (x20), (F) C-MYC (+) (x20).
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The immunohistochemical (Figure 2) hinted tumor cells CD20 (+), CD79a (+), PAX-5 (+), Bob-1 (+), Oct2 (+), CD10 (+), BcL-2 (+), Bcl-6 (+), CD15 (-), CD30 (+), CD23 (+), CD21 (+), MUM1 (+) and Ki-67 (+ >30%).
(A and B) PET/CT on January 14, 2016, showed T8-10 vertebral body, retroperitoneal enlarged lymph nodes, left iliac bone and left femur with increased uptake of 18F-FDG. (C and D) PET/CT on May 12, 2016, showed that18F-FDG uptake concentration in the original area all disappeared.
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After four cycles of chemotherapy with R-CHOPE, PET/CT on May 12, 2016 (Figure 3C and D) suggested that, compared with PET/CT on January 14, 2016, 18F-FDG uptake concentration in the original area all disappeared, suggesting that the tumor was relieved.