PMC6744749_01
(a) Gadolinium contrast-enhanced magnetic resonance imaging demonstrated inflammation of vertebral body at L3 and L4 with bilateral iliopsoas abscesses. (b) Microscopy of the surgical specimen of the vertebral interbody revealed granuloma aggregating of histiocytes by hematoxylin and eosin staining at low magnification. A punctured specimen from the abscess of iliopsoas muscle demonstrated Mycobacterium tuberculosis in the Ziehl-Neelsen stain at high magnification (left upper).
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F1
He was diagnosed with bacterial spondylitis and iliopsoas abscess [Figure 1a]. M. tuberculosis was detected from the abscess, and caseous granuloma was identified pathologically in surgical specimens of the intervertebral disk [Figure 1b].
Magnetic resonance images showed a nodular lesion with ring enhancement by gadolinium contrast medium in the cerebellar hemisphere extending to the vermis, compressing fourth ventricle (upper 2 slides). The lesion was associated with perifocal edema and bilateral ventriculomegaly (lower 2 slides).
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F2
Magnetic resonance (MR) images revealed a nodular enhanced lesion in the right cerebellar hemisphere extending to the vermis associated perifocal edema and bilateral ventriculomegaly [Figure 2].
Operative view: A lesionectomy was performed by opening the cerebellomedullary fissure, and a well-circumscribed mass with gray color encircled by arrowhead was identified (left). Total mass resection was performed (right).
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F3
A well-circumscribed mass with gray color was identified by opening the cerebellomedullary fissure [Figure 3]. A mass of 3.5 cm was extracted [Figures 3 and 4].
(a) Operative view: A lesionectomy was performed by opening the cerebellomedullary fissure, and a well-circumscribed mass with gray color encircled by arrowhead was identified (left). Total mass resection was performed (right). The size of the extracted mass was 3.5 cm. Pathology of the lesion revealed lymphocytes, macrophages, plasmacytes, and neutrophils aggregated around the tuberculoma by hematoxylin and eosin staining at 200-fold magnification (upper left). (b) Postoperative MRI showed a total mass resection.
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F4
A mass of 3.5 cm was extracted [Figures 3 and 4]. Postoperative MR images revealed total removal of the lesion [Figure 4b].