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Dr. M. Nabil El Bolkainy

Ph. D. (Path.) Michigan, U.S.A.

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Clinical:

Spinal cord lesion.

Age: 20

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Referred By: Pro!

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Name:

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Ph. D. (Path.) Cairo University

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Dr. Tarek N. El Bolkainy

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Sex: Male

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Gross
0.5 mm.

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Microscopic

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Extremely scanty tissue, mostly fibrosis, inadequate for evaluation.

neurofibroma.

The lesion is possibly a

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Diagnosis
Spinal cord, Biopsy:

Very scanty material.

Category
Inadequate sample.

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Date

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06/06/2010

MD. Ph. D.

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Jf.C-:Moustafa iMosque

Time:

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oftlie dorsal spine witli contrast: rteclinique: o/aria6fe pulse sequences were taR.!n 6efore and after C}d-anp')1. injection.

Pincings:
- No prior films, surgical
- This study

revealed

SOL seen

from

large,

oval,

to L2 levels,

010

of prior

surgical

repotted

ill defined,

of its solid component.

enhancement
- Evidence

or pathological

available.
partially

it has low

solid,

T1W,

partially

high

It causes mild expansion

intervention

In

the

form

cystic

intre-mec'ulietv

T2 W signals

with

intense

of the cord.
of

extended

dorsolumbar

spinolaminectomy.

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- No other

MRI abnormalities

seen.

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Opinion: - Recurrent

/ residual

intra-medullary

ependymoma.
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Jf.ss. rFrof. Hos

/I~tle{ 'Kader :M(j).

SOL ~s reported

mostly

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astrocytoma

or

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Patient name: ~
DATE: 9-6-2012
Dear Prof. o-.

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Report

The study was performed on a 0.5 Tesla super conducting system.

Variable pulse sequences were taken.

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Status post D12-L1 down to L2-L3 spinolaminectomy, no
operative data, no previous films yet the current study revealed:- The operative bed shows small extra medullary intra spinal oblong
shaped soft tissue mass lesion opposite D 11 & D 12 levels
measuring 4x1.5cm being hypointense on Tl WI and isointense on
T2WI with intense homogenous enhancement after LV Gd-DTP A
administrati on.
- Mild lumbar spondylosis with marginal osteophytic lipping.
- Normal alignment of the visualized part of the spine.
- No evidence of disc degeneration detected.
- No evidence of bony canal stenosis.
- The visualized part of the cord and conus appear of normal size,
shape and signal intensity with no abnormal masses detected.
- Normal MRI structural appearance and signal intensity of the
scanned discs, with no evidence of disc pathology.
- Intact vertebral bodies that appear of normal signal.
- No facet joint arthropathy.
- Normal MRl appearance of retro and para spinal soft tissue
structures.
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-Status post D12-L1 down to L2-L3 spinolaminectomy with

operative bed extra medullary recurrent/residual enhanced mass
lesion for clinical correlation.
MUCH OBLIGED
DR. AYMAN EZZAT
DR. MOHAMED AMIN M.D
Checked by:

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SAYED GALAL UNIVERSITY

Radiology Department

HOSPITAL

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REPORT

MRl UNIT

Patients Name: MOHAMED SAYED

MRI OF THE DORSOLUMBAR

DATE:-20/12/20.12

SPINE :

TECHNIQUE:
~ Sagittal T1 & T2 -WI
~Axial
T2-WI

'"Post contrast
FINDINGS.
o Siaiu.s post spinolaminectomy
of D12 and L1 vertebrae.
Compared
to the last previous MRI study dated 6-9-2012, the

current study revealed:

Stationary rather than slight proqressiue coarse as reqardinq- th.e
size, shape enhancement pattern of the previously noted complex
intra uiedullari] .lesion . with solid intensely enhanced upper
component
opposite
D 1 .1-D12 vertebral
bodies
m.easu.ring
4.5x2c711 and lower multi-locular cystic component opposite [:1-2
vertebral levels measuring 9x2cm and shows faint enhancement.~
~ No newly developed lesions.
Diffuse fatty marrow marrow changes of the lower dorsal &
lumbar vertebrae ( likely post therapy changes).
\~lVIildly dilated central canal of the lower dorsal cord ( lower
dorsal syringomyation
).
IiI The remainder
of the study is unremarkable.

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fill

MUCH OBLIGED, YOURS

DR. HUSSEIN MONTASR MD

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WAEL

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CAIRO PATHOLOGY LAB (C.P.L.)

Dr. MOHAMED ELKATEB
Prof. of Pathology
Faculty of Medicine
Referred by Prof. Dr. : Sayid Galal H.
Patient's name
: Mohamed Sayid Hussein
Age
: 24 years
Sex
: Male
Clinical diagnosis
: D 11 - D 12 S.O.L.
Specimen
: Biopsy

Date received
31112/2012
Delivery date
31112013

Slides 1
Photos 1

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Report
Patient name: ~

DATE: 23-07-2013
DEAR PROF.DR.

Variable pulse sequences were taken.

Status post-operative and radio-therapy ora known case, histologically

proved spinal cord lower aspect dorsolumbar aspect cellular schwannoma
follow up compared with the last available MRl study. dated on 9-6-2012. the
current study has revealed:- Prominent and dramatic regression and almost complete resolution of the
previously reported lower dorsal (DII & DI2) level intra-spinal enhanced
lesion, with stationary course or slight insignificant regression of the
associated ill-defined intra-spinal associated component. After LV contrast
injection the residual component shows faint heterogenous enhancement.
- No newly developed lesion.
- Diffuse fatty marrow changes of the lower dorsal and lumbar vertebral as
post-radiotherapy sequela.
- The remaining of the study is unremarkable.

MUCH OBLIGED
DR. WAEL EL-SHAWAF M.D
DR. AYMAN SHABAYEK
Checked by Dr: M.M
Typed by: R.B.E

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EMG report
Dear Pro! Dr Moliamed Refaat, thank youfor your referral
QEMG examination
and nerve conduction studies were carried out to the EDB, t
anterior. medial gastrocnemius,

long and short head of biceps, vastus med muscles

bilaterally, as well as the common peroneal, posterior tibial and med plantar nerves.
The examined muscles at rest showed increased insertional activity, and denervation
potentials in the form of fibs at rest.
On attempt of voluntary contraction the examined muscles on the left side showed absent
MUP (no action).
The right side muscles show MUP of severely
amplitude, increased

reduced

recruitment, severely

reduced

polyphasicity and duration.

studies of both posterior tibial nerves showed normal ankle -

Motor nerve conduction

AH distal conduction time, reduced amplitude of the CMAP, increased

duration

and

normal ankle -knee conduction velocities.

Motor

nerve

conduction

studies

of both common peroneal nerves showed absent

responses
studies of both medial plantar nerves showed normal ankle

Sensory nerve conduction

- AH distal conduction time, reduced amplitude of the CMAP, and normal conduction
velocities.

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Conclusion:

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QEMG examination

and nerve conduction studies show evidence of low amplitude,

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broad nerve conduction

studies on stimulation of tibial and sensory nerves, bilaterally

with absent peroneal nerve responses

Emg examination shows absent MUAP in the left sided examined muscles.
The right side muscles shows severely neurogenic EMG picture.
There is evidence of signs of ongoing denervation all examined muscles.
For correlation with the condition.

Sahna :M.arzou~ :M.(j)

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WATANI RADIOLOGY CENTRE

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watani

Name: Mr. Mohamed Al-Sayed Hussin

Ref.Prof.Dr.: A/aa Abdel Hay
Date: 1511012014

Pre and post-contrast MRI examination of the Dorsolumbar spine

Techniques:
Sagittal T I and T 2 WIs.
Axial T 1 and T 2 Wls.
Post-contrast axial and sagittal T f Wls.
Findil1gs:

There are post-operative changes related to DIO-I1 down to LI-2

spinolaminectomies with posterior sagging of the thecal sac for excision
of histopathologically proved spinal cord, dorsolumbar aspect. cellular
Schwannoma.
There are changes related to D10 down to L4 radiotherapy yellow
marrow conversion.
No residual or recurrent significantly enhanced mass lesion at operative
~bed, however, there is enhanced septations at DIO down to L2 vertebral
bodies.
Partial spastic straightening of lumbar curvature.
Mild degenerative spondylosis with disc desiccations and relative
reduced disc heights at DIO-II down to DJ2-L1 and Ll-2.
Normal conus medullaris and cauda equina roots.
No evidence of paraspinal soft tissue abnormality could be seen.

Opinion:
Stationary course as regard post-operative changes related to DIO-ll down to Ll-2
spinolaminectomies
and posterior sagging of the thecal sac as well as
heterogeneously enhanced septations.
Stationary course as regard DIO down to L4 post-radiotherapy yellow marrow
converston.
Mild degenerative spondylosis.
No obvious significantly enhanced mass lesion at operative bed.
Best regards
A.ProfDr. Ashraf Enite, MD

10 El Sebok St.. Merryland

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- Heliopolis - Cairo
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