case_images: PMC3463837_01
case_images: (a) T1-weighted contrast sagittal image showing the tumor with irregular margin and intense enhancement on contrast. Bodies of T8 and T9 vertebrae show infiltration. (b) T1-weighted contrast axial image showing the enhancing tumor surrounding and compressing the tumor from all side like a cylinder. (c) Coronal image showing the infiltrative nature of the tumor
case_images: SNI-3-96-g001.jpg
case_images: PMC3463837_01_SNI-3-96-g001.jpg
case_images: F1
case_images: On MRI, there was a grossly infiltrating lesion at the level of T8, T9 and partially extending to T10 level [Figure 1a and c]. T9 vertebral bodies. The lesion was extradural compressing the cord all around like a cylinder which was well seen in the axial cut [Figure 1b]. The lesion had an irregular margin with intense homogenous enhancement on the gadolinium contrast image.
case_images: Tumor specimen showing the pinkish white color, soft, friable nature of the tumor
case_images: SNI-3-96-g002.jpg
case_images: PMC3463837_01_SNI-3-96-g002.jpg
case_images: F2
case_images: Just beneath the laminae a vascular, pinkish white, friable, soft mass found [Figure 2] completely carpeting the cord from all sides.
case_images: (a) Routine staining show pleomorphic, large cells with abundant cytoplasm (arrowhead) with large numbers of lymphocytic infiltrate (long arrow). (b) Numerous mitotic figures (arrow). (c) Tumor giant cells (arrow). (d) Emperipolesis: Phagocytosis of red cells, leukocytes and tumor cells by the histiocyte
case_images: SNI-3-96-g003.jpg
case_images: PMC3463837_01_SNI-3-96-g003.jpg
case_images: F3
case_images: Histopathology showed sheets of large, pleomorphic, mononuclear cells showing marked cytologic atypia admixed with large no of lymphocytes [Figure 3a]. Cells were large epithelial like with abundant pale eosinophilic cytoplasm with oval to irregular nuclei, vesicular chromatin, prominent nucleoli with numerous mitotic figures [Figure 3b]. There were binucleate and multinucleated giant cells [Figure 3c]. Few areas showing phagocytosis of red cells, leukocytes, and tumor cells by the histiocytes called emperipolesis [Figure 3d] were seen.
case_images: Immunohistochemistry with S-100 positivity
case_images: SNI-3-96-g004.jpg
case_images: PMC3463837_01_SNI-3-96-g004.jpg
case_images: F4
case_images: S-100 [Figure 4], CD68 [Figure 5], and particularly lysozyme [Figure 6] and was negative for CD1a, CD21, langerin suggesting the final diagnosis as histiocytic sarcoma. Staining for myeloperoxidase, CD34, and CD117 were negative excluding myeloid sarcoma.
case_images: CD68 immunopositivity
case_images: SNI-3-96-g005.jpg
case_images: PMC3463837_01_SNI-3-96-g005.jpg
case_images: F5
case_images: S-100 [Figure 4], CD68 [Figure 5], and particularly lysozyme [Figure 6] and was negative for CD1a, CD21, langerin suggesting the final diagnosis as histiocytic sarcoma. Staining for myeloperoxidase, CD34, and CD117 were negative excluding myeloid sarcoma.
case_images: Lysozyme immunopositivity
case_images: SNI-3-96-g006.jpg
case_images: PMC3463837_01_SNI-3-96-g006.jpg
case_images: F6
case_images: S-100 [Figure 4], CD68 [Figure 5], and particularly lysozyme [Figure 6] and was negative for CD1a, CD21, langerin suggesting the final diagnosis as histiocytic sarcoma. Staining for myeloperoxidase, CD34, and CD117 were negative excluding myeloid sarcoma.