PMC3401660_01
Contrast-enhanced Sagittal T1-weighted MRI showing intramedullary abscess with rim enhancement extending from D6 to conus level
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F1
T1, heterogeneously hyperintense on T2WI. T1 fat suppressed Gadolinium-enhanced sequences revealed peripheral enhancement with central hypointense areas from D6 vertebral level to conus medullaris consistent with inflammatory collection [Figures 1 and 2].
Sagittal T2-weighted sequence showing expansion of cord and dilated central canal from cervicomedullary junction to C7 with hyperintense signals from intramedullary portion of cord signifying liquefaction from D1 to D6 level
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F2
T1, heterogeneously hyperintense on T2WI. T1 fat suppressed Gadolinium-enhanced sequences revealed peripheral enhancement with central hypointense areas from D6 vertebral level to conus medullaris consistent with inflammatory collection [Figures 1 and 2].
H and E stain shows characteristic tubercular lesion depicting epithelioid cell granulomas along with Langhans giant cell surrounded by rim of lymphocytes and central focal necrosis (40x)
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F3
It also showed significant syrinx formation from D1 to D6 vertebral level with evidence of altered signal intensity in cord parenchyma [Figure 3].
Ziehl-Neelsen staining showing AFB-positive bacilli (100x)
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F4
Histopathological examination showed the presence of chronic inflammatory cells with caseating epithelioid cell granuloma and ZN staining was also performed on sections which showed AFB positive bacilli [Figures 4 and 5].