PMC6744822_01
Upper image: T2 axial image of the lesion surrounding the catheter (red arrow). The granuloma appears as an extra-axial lesion isodense to the myelon. Lower image: T1 contrast sagittal image showing a space-occupying, ring-enhancing, inhomogeneous, extra-axial mass (red arrow) in the spinal canal at the level of T4.
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F1
April 2018, she presented with new-onset paresthesia sub-T5. A magnetic resonance imaging (MRI) of the spine showed high-grade compression of the spinal cord (with compression-induced myelomalacia) at T3-T5 corresponding to the location of the catheter tip with suspicion of a catheter-tip-associated granuloma [Figures 1 and 2].
T2 sagittal image of the same lesion with clearly visible extensive T2 signal changes in the spinal cord. The tip of the catheter is seen encased in the granuloma substance (red arrow).
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F2
April 2018, she presented with new-onset paresthesia sub-T5. A magnetic resonance imaging (MRI) of the spine showed high-grade compression of the spinal cord (with compression-induced myelomalacia) at T3-T5 corresponding to the location of the catheter tip with suspicion of a catheter-tip-associated granuloma [Figures 1 and 2].
T1 contrast imaging. Upper image: Axial image showing a large recurrence overshadowing and compressing the spinal cord (pink arrow). Lower image: The recurrent granuloma is seen here as a large, ring-enhancing, inhomogeneous, mass-causing high-grade compression of the spinal cord (pink arrow).
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F3
A cervical and thoracic MRI [Figure 3] showed a mass suspicious for a catheter-tip granuloma causing a compression of the thoracic spine at T7-T11 associated with a secondary myelomalacia now extending proximally to the conus medullaris.