Teaching NeuroImages: Myeloperoxidase–anti-neutrophil cytoplasmic antibody–positive hypertrophic pachymeningitis

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Teaching NeuroImages: Idiopathic hypertrophic spinal pachymeningitis mimicking epidural lymphoma.

A 41-year-old man presented with bilateral leg numbness and paraparesis for 3 months. MRI showed a circumferential long epidural mass extending from T2 to T4 level (figure 1). Histologic examination demonstrated dense fibrous tissue with inflammatory infiltrate (figure 2). By exclusion of trauma, infectious diseases, and autoimmune diseases, idiopathic hypertrophic spinal pachymeningitis (IHSP)...

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Resident & Fellow Rounds.

Teaching NeuroImages: Myeloperoxidase–anti-neutrophil cytoplasmic antibody–positive hypertrophic pachymeningitis A woman in her 40s presents with painless monocular vision loss and is found to have optic perineuritis and dural thickening. Comprehensive laboratory testing,MRI of the brain, and dural biopsy reveal a diagnosis of myeloperoxidase–antineutrophil cytoplasmic antibody–positive hypertr...

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Teaching NeuroImage: idiopathic hypertrophic spinal pachymeningitis.

A 42-year-old woman had progressive numbness from both feet to mid chest for 2 weeks. Examination showed a sensory level at T8, no weakness, and brisk reflexes throughout. MRI showed T2–T5 dural thickening (figure 1). Testing revealed an elevated sedimentation rate and normal chest x-ray, CSF analyses, and tests for rheumatologic diseases and infections. Dural biopsy showed an inflammatory infi...

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IgG4-related hypertrophic pachymeningitis coexpressing antineutrophil cytoplasmic antibodies

IgG4 disease was first described in 2001 in a seminal paper by Hamano and colleagues: Syndrome of exocrine gland infiltration with associated raised serum IgG4 levels. IgG4 disease is manifested by the hallmark histopathologic features of lymphoplasmacytic infiltration of IgG4-positive plasma cells, storiform fibrosis, and obliterative phlebitis. Hypertrophic pachymeningitis (HP) has been incre...

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Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Complicated by Periaortitis and Cranial Hypertrophic Pachymeningitis: A Report of an Autopsy Case

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic inflammatory disorder categorized as small-vessel vasculitis. We herein report an elderly Japanese man with AAV (granulomatosis with polyangiitis affecting the eyes, nose, lungs, and kidneys) who also showed periaortitis at the diagnosis and developed cranial hypertrophic pachymeningitis (HP) during steroid maintenan...

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ژورنال

عنوان ژورنال: Neurology

سال: 2017

ISSN: 0028-3878,1526-632X

DOI: 10.1212/wnl.0000000000004673