PMC7566203_01
Plain X-Ray. Left: Chest X-Ray AP view showed homogenous consolidation at the right upper lung. Middle: Thoracolumbal X-Ray AP view showed normal finding. Right: Thoracic X-Ray lateral view demonstrated no abnormalities.
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Plain chest X-Ray, thoracolumbal, and lateral radiographs revealed normal finding (Fig. 1).
Resected specimen of intramedullary mass.
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The hypointense portion reflected necrosis and also hypocellularity with increased macrophages and gliosis. The pathological layers were indistinguishable on T2-weighted image (Fig. 2). The patient suspected with intramedullary mass spinal tumour.
MRI sagittal view. Left: T1-weighted image showed intramedullary hypointense mass within T6. Right: T2-weighted image demonstrated low signal intensity in T6 level.
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Midline durotomy was perfomed and showed a thick mass intramedullary tumour at the vertebral level of thoracal VI, VII, and VIII (Fig. 3).
Histopathology. Top: This picture demonstrated granuloma with caseous necrosis. Histopathology revealed a granulomatous lesion with a central area of caseation in keeping with a tuberculoma (asterisk). Middle: Multiple giant cells and inflammatory cells at 10x magnification. Some histiocytes are forming multinucleated giant cells (arrow). Bottom: Epithelioid cells granuloma at 40x magnification. Edge of a necrotizing granuloma seen in a peripheral rim of epithelioid histiocytes (arrows) surrounding the central necrotic region (asterisk). External to the rim of histiocytes is an outer rim of lymphocytes and plasma cells.
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These pictures below were suggestive for tuberculoma of the spinal cord (Fig. 4).
Axial T1-weighted MRI of T6 level, showing an intradural hypointense mass.
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T6 level (Fig. 5).