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Paraganglioma Case Study

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Paraganglioma is a rare neoplasm of neuroendocrine origin which may develop at many different anatomical sites including head and neck, thorax, and abdomen. The occurrence of paraganglioma in lower spine is rare, but well established as one of the differential. The investigation of choice pre-operatively is magnetic resonance imaging4, which usually shows a very well circumscribed partially cystic mass which is iso- or hypointense to spinal cord on T1-weighted images, and hyperintense on T2-weighted images4. These MRI features are similar to other cauda equine tumors such as ependymoma2. However sometimes MRI may show serpentine congested ectatic blood vessels with “cap sign” (a low intensity signal rim) on T2-weighted images which are considered diagnostic for paragangliomas2,7.

There have been quite a few instances where paragangliomas, ependymomas, and/or other cauda equine tumor diagnosis has been difficult to differentiate. In fact the first case of paraganglioma was published in 1970, even though it was initially thought to be an ependymoma4. Some authors have also suggested co-existence of paragangliomas and ependymomas1, as well as having overlapping histology with …show more content…

Zellballen can also be seen on cytology, described as nest-like clusters of uniform, round-to-polygonal chief cells surrounded by richly vascular tissue and sustentacular (type2) cells2,5.
Cytological features of ependymomas- myxopapillay ependymomas are usually the predominant type of ependymomaas in cauda equine region9. The cytological findings include round to spindle-shaped cells, arranging as loose clusters with papillary branching9. The cells have indistinct boundaries, and the cytoplasm is tapering, looks fragile and

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