case_images: PMC9747317_01
case_images: Transverse view of the cervical spine at the level of C8 at the level of nonenhancing material (white arrow), (a) T2 FS Dixon, (b) T1 precontrast, (c) T1 postcontrast, and at the nerve root level (white arrowhead), (d) T2 FS Dixon, (e) T1 precontrast, and (f) T1 postcontrast. There is moderate enlargement, heterogeneity, and contrast enhancement along the right ventral C8 nerve.
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case_images: fig1
case_images: C6 to T1. The tissue was contiguous with the right ventral C8 nerve root (Figure 1) and to a lesser degree with the C7 nerve root, both of which were contrast enhancing and enlarged, expanding to the intervertebral foramina. The tissues surrounding the right C6-7 articular facet were T2 hyperintense and contrast enhancing. Compared to other facets of the caudal cervical spine, this facet was enlarged, resulting in mild spinal cord compression (normal signal of the spinal cord).
case_images: Gross pathology dorsal view of the vertebral column. The dorsal vertebral processes and spinal cord removed, exposing the ventral aspect of the intervertebral canal. (a) Vertebral column from C1 to T3. (b) Vertebral column from C6 to T1, inset of Figure 1(a). Within the right ventrolateral aspect of the intervertebral canal from C6 to T1 are aggregates of pale tan to pink, soft, gelatinous exudate (arrowheads). Exudate extended into the right intervertebral foramina between C5-C6, C6-C7, and C7-T1. Cr: cranial aspect; Cd: caudal aspect; R: right; L: left; C1-T3: approximate locations of each of the cervical and thoracic vertebrae.
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case_images: fig2
case_images: On gross postmortem examination (Figure 2), the right ventrolateral aspect of the intervertebral canal from C6 to T11 contained multifocal loosely adhered, plaque-like aggregates of opaque, pale tan to pink, soft, and gelatinous exudate that extended into the right intervertebral foramina between C5-C6, C6-C7, and C7-T1.
case_images: Histopathology micrograph. Intravertebral adipose tissue H&E, region of C6-C8. (a) The intravertebral adipose tissue is variably effaced by inflammation, fibrin, and necrosis. (b) Higher magnification view of the inflammation revealed an infiltrate composed of large numbers of neutrophils and macrophages admixed with abundant fibrin. No pathogens were noted.
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case_images: fig3
case_images: Histopathological evaluation revealed suppurative steatitis (Figure 3) with C6-C8 region more severely affected, involving the epidural fat, perineural adipose tissue surrounding the right-sided C7 and C8 nerve roots, and the perimysium of the surrounding muscle.
case_images: Histopathology micrograph, Kidney H&E. (a) Within the grossly red renal foci, the renal medulla was multifocally effaced by suppurative foci. (b) Higher magnification view of the infiltrating neutrophils and macrophages, the latter of which often contained granular to globular, eosinophilic, intracytoplasmic phagocytic debris (arrow). No pathogen were noted.
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case_images: fig4
case_images: The renal parenchyma (Figure 4) was multifocally effaced by inflammation and necrosis, similar to that seen in the epidural adipose tissue.