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AJNR - American Journal of Neuroradiology

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Inflammatory Pseudotumor in the Epidural Space of the Thoracic Spine: A Case Report and Literature Review of MR Imaging Findings

Ho Jun Seol^a,d, Sam Soo Kim^a,d, Ji Eun Kim^b, Sang Hyung Lee^c and Jun Yeon Won^a,d

^a Department of Neurosurgery, Kangwon National University College of Medicine, Chuncheon, Korea
^b Departments of Pathology, Seoul Municipal Boramae Hospital, Seoul, Korea
^c Departments of Neurosurgery, Chuncheon, Korea
^d Neuroscience Research Institute, Kangwon National University College of Medicine, Chuncheon, Korea

View larger version (111K): [in a new window]   FIG 1. Thoracic spine CT scan shows an epidural mass compressing the spinal cord without bony destruction.

View larger version (122K): [in a new window]   FIG 2. MR imaging demonstrates the expansile epidural mass from T1 to T7, showing heterogeneous iso- and hyperintensity on the sagittal T2-weighted image (A) and homogeneous isointensity on the T1-weighted image (B). The postcontrast sagittal (C) and axial (D) images reveal a homogeneous enhancing lesion with cord compression. There is no abnormality in the adjacent bone.

View larger version (175K): [in a new window]   FIG 3. Microscopically, there is a polymorphic infiltrate composed of plump myofibroblasts (arrows) and lymphoplasma cells in loose fibromyxoid stroma, suggesting inflammatory myofibroblastic tumor (hematoxylin and eosin, original magnification x100).

View larger version (123K): [in a new window]   FIG 4. A, Abundant inflammatory cells such as plasma cells (arrow) in rich vascular stroma are seen in some areas (hematoxylin and eosin, original magnification x200.) B, Paucicellular area shows platelike collagen resembling scar tissue (hematoxylin and eosin, original magnification x200).