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AJNR - American Journal of Neuroradiology

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Lumbar Disk Pseudotumor: An Unusual Presentation of Lumbar Spinal Fracture and Stenosis

Robert A. Koenigsberg^a, Perry Black^a, Scott H. Faro^a and Jeffrey Rykken^a

^a Department of Radiology, Drexel University College of Medicine, Philadelphia, PA
^b Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, PA

View larger version (89K): [in a new window]   FIG 1. MR sagittal T2-weighted image shows an expansile mass at the L2-L3 disk level that represents the pseudotumor. The disk attached to the inferior L2 endplate has increased signal intensity. Spinal stenosis is present at the L2-L3 and L3-L4 levels.

View larger version (89K): [in a new window]   FIG 2. Gadolinium-enhanced T1-weighted sagittal MR image shows endplate enhancement at the L2-L3 level.

View larger version (89K): [in a new window]   FIG 3. Sagittal CT reconstruction of the lumbar spine shows a disk-space mass with an extension deformity. Note the laminar calcification along the anterior vertebral margins disrupted by the disk-space mass and the facet malalignment.

View larger version (90K): [in a new window]   FIG 4. Axial CT scan (bone window) at the L2 level shows bilateral pedicle fractures. Note the moth-eaten appearance of the L2 endplate simulating an underlying destructive mass.

View larger version (90K): [in a new window]   FIG 5. Axial soft tissue–window CT scan (soft tissue window) at the level of the L2-L3 disk space demonstrates severe central-canal stenosis. This finding was also apparent at the L3-L4 level (not shown).

View larger version (71K): [in a new window]   FIG 6. Low-power photomicrograph shows reparative granulation tissue (solid arrows) and a proliferation of capillaries. Bone (open arrow on the left) and cartilage (open arrows on the right) are adjacent to the granulation tissue.

View larger version (71K): [in a new window]   FIG 7. Medium-power photomicrograph shows extensive fibrin stroma (pink) with scattered fibroblasts (elongated cells) and inflammatory cells (lymphocytes and polymorphonuclear cells).