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Case Reports
. 2018 Oct;97(41):e12586.
doi: 10.1097/MD.0000000000012586.

Pathological features of paraganglioma in the lumbar spinal canal: A case report

Zhe-Hui Wang  1 , Yuan-Tao Wang  2 , Fei Cheng  3 , Yu Hu  1
Affiliations
Case Reports

Pathological features of paraganglioma in the lumbar spinal canal: A case report

Zhe-Hui Wang et al. Medicine (Baltimore). 2018 Oct.

Abstract

Introduction: This study aims to investigate the pathological features of a patient with paraganglioma in the lumbar spinal canal.

Case presentation: The patient was 36 years old male with electrical pain in the waist and buttock which occurred intermittently, and was not relieved under oral use of analgesics. Immunohistochemical staining was performed to diagnose the disease. The results revealed that the size of the tumor was 3.4 × 1.6 × 1.4 cm. The hematoxylin and eosin (H&E)-stained tumor cells mainly presented with an organ-like arrangement under low power microscope, showing prominent chrysanthemum-like, pseudo glandular or pseudo papillary arrangements. The surrounding area of the nest presented with sinusoids, and fibrosis and focal calcification could be observed in the interstitial space among the lesions. Immunohistochemistry results showed that the chief cells were positive for neuron-specific enolase (NSE), Syn and CgA, and Sertoli cells were positive for S-100.

Conclusion: Paraganglioma is a very rare malignant tumor. This tumor should be distinguished from ependymoma, meningioma and hemangioblastoma, to avoid misdiagnosis, and missed diagnosis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
CT results: an irregular mass with a slightly high density was found at the spinal canal from the L2-5 vertebrae, the size is 7.1 × 2.2 cm, depression induced by compression was found in the posterior lumbar region, and scattered fine calcifications could be seen. CT = computed tomography.
Figure 2
Figure 2
Under H&E staining with a ×40 low power microscope, the tumor cells presented with a nest-like arrangement, and fine sinusoids were observed around the tumor. H&E = hematoxylin and eosin.
Figure 3
Figure 3
Under H&E staining with a ×40 low power microscope, the tumor invaded the surrounding bone tissue. H&E = hematoxylin and eosin.
Figure 4
Figure 4
Immunohistochemical result: the cytoplasm was positive for Syn.
Figure 5
Figure 5
Immunohistochemical result: the cytoplasm was positive for CgA.
Figure 6
Figure 6
Under H&E staining at ×40, Ki-67 was approximately 1%.
See this image and copyright information in PMC

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