Radiology Quiz 19563 | Radiopaedia.org

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How do solitary fibrous tumours of the spine differ from those of the intracranial compartment?

Spinal solitary fibrous tumours may be intradural extramedullary or intramedullary, however the majority are intramedullary (as is seen in this case). In contrast to intracranial solitary fibrous tumours, which usually show a dural origin, spinal SFTs usually do not demonstrate a dural attachment.

Histology

MACROSCOPIC DESCRIPTION: Spinal cord tumour: A piece of rubbery pink to fawn tissue 20x5x6mm.

MICROSCOPIC DESCRIPTION: The sections show a well-demarcated tumour with hyper and hypocellular areas. In the cellular areas, the tumour forms short fascicles. The tumour cells have elongated nuclei, hyperchromasia and scanty ill-defined cytoplasm. 1 mitosis per 10 high power fields is seen. Some staghorn type blood vessels are present in the background, which is focally fibrosed, containing keloidal-type collagen bundles. No necrosis is identified. The tumour cells are CD34 and CD99 positive. Factor XIIIa is focally and weakly positive. They are EMA, AE1/3, S-100 and Melan-A negative. The Ki-67 index is about 4%. The features are in keeping with a solitary fibrous tumour.

FINAL DIAGNOSIS: Spinal cord tumour: Solitary fibrous tumour of the spinal cord.