PMC5535511_01
Gadolinium-enhanced T1-weighted sagittal (a) and axial (b) magnetic resonance images depicting the catheter-associated intrathecal granuloma. T2-weighted sagittal image (c) depicts extensive hyperintensity from the T4 level to the conus. T2-weighted axial image (d) depicts spinal cord compression from the dorsal intrathecal granuloma
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F1
Spinal imaging was performed [Figure 1].
Microscope images obtained during resection of the intrathecal catheter-associated granuloma. (a) Prior to resection, the granuloma (chevron) surrounded the distal end catheter (arrowhead). (b) The granuloma (at left) was separated from the distal end of the catheter (right) and spinal cord. Image orientation, cephalad at left
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F2
The exposed dura was incised, revealing an adherent, 1.2 cm x 0.6 cm x 0.5 cm, soft tissue mass just proximal to the terminus of the intrathecal catheter [Figure 2]. The mass was completely dissected from the dura and the catheter.
Histologic examination of the catheter mass demonstrated dense fibrous tissue with necrotic debris and chronic inflammation composed of histiocytes and small mature lymphocytes, consistent with granuloma (hematoxylin and eosin preparation; x20 magnification)
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F3