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Atypical spinal tuberculosis mimicking malignancy: the utility of multimodality imaging evaluation
  1. Dr. Timothy Shao Ern Tan,
  2. Dr. Rameysh Danovani Mahmood
  1. Department of Radiology, Changi General Hospital, Singapore
  1. Correspondence to Dr Timothy Shao Ern Tan, Department of Radiology, Changi General Hospital, Singapore; timothy.tan.shao.ern{at}doctors.org.uk

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A previously well 50-year-old woman presenting with 2 months of worsening cough and back pain underwent a chest radiograph that incidentally revealed thoracic paravertebral soft-tissue swelling (figure 1). Further CT and MRI work-up showed a destructive T8–T10 paravertebral mass with associated vertebral abnormalities causing mild cord compression, along with multiple pulmonary and hepatic nodules (figure 2), overall suspicious for metastatic malignancy. The mass was subsequently sampled and drained under CT guidance, demonstrating caseating granulomata with acid-fast bacilli, thus confirming the diagnosis of spinal tuberculosis.

Figure 2

MRI of the thoracolumbar spine with (A: sagittal) short tau inversion recovery (STIR) and (B: sagittal, C: axial—T8/T9 level) …

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Footnotes

  • Contributors TSET conceptualised and drafted the manuscript. RDM critically reviewed and revised the manuscript. All authors contributed to finalising the manuscript as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Consent obtained directly from patient(s).

  • Provenance and peer review Not commissioned; internally peer reviewed.

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