Imaging findings of cryptococcal infection of the thoracic spine

Abstract

Cryptococcosis with thoracic spine involvement is extremely rare, with most cases occurring in immunosuppressed patients. We report a case of cryptococcosis of the thoracic vertebrae confirmed by histopathology. The immunocompetence of the patient is a most interesting feature of this case. Laboratory investigations were normal, but the erythrocyte sedimentation rate was raised. A computed tomography scan showed an eccentric lytic lesion with a clear boundary at T2–T3. Magnetic resonance imaging showed the endplates of the T2 and T3 vertebral bodies to be involved, but without significant loss of the intervertebral disk height. A prespinal and large paraspinal soft tissue component was spreading along T1–T4, and the pleura and dural sac at the level of T2–T3 had thickened abnormally. 18F-fluorodeoxyglucose positron emission tomography/computed tomography showed abnormal uptake in the lesion. The above-mentioned clinical and imaging information will help improve our understanding of this rare disease.

Keywords

• Cryptococcosis
• Infection
• Thoracic spine