Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors: Diagnostic considerations

Douglas Kazutoshi Sato; Tatsuro Misu; Cristiane Franklin Rocha; Dagoberto Callegaro; Ichiro Nakashima; Masashi Aoki; Kazuo Fujihara; Marco Aurelio Lana-Peixoto

doi:10.1177/1352458513505350

Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors: Diagnostic considerations

Douglas Kazutoshi Sato, Tatsuro Misu, Cristiane Franklin Rocha, Dagoberto Callegaro, Ichiro Nakashima, Masashi Aoki, Kazuo Fujihara, Marco Aurelio Lana-Peixoto

Research output: Contribution to journal › Review article › peer-review

10 Citations (Scopus)

Abstract

Two patients with longitudinally extensive myelopathy were initially biopsied for suspected spinal cord tumors. Both patients were later diagnosed with neuromyelitis optica spectrum disorders (NMOSD) supported by their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immunohistochemical staining demonstrated findings compatible with acute NMOSD lesions in one case while the other case exhibited findings consistent with chronic NMOSD lesions. A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD.

Original language	English
Pages (from-to)	621-626
Number of pages	6
Journal	Multiple Sclerosis Journal
Volume	20
Issue number	5
DOIs	https://doi.org/10.1177/1352458513505350
Publication status	Published - 2014 Apr

Keywords

Neuromyelitis optica
aquaporin-4
biopsy
differential diagnosis
pathology
spinal cord tumor

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1177/1352458513505350

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title = "Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors: Diagnostic considerations",

abstract = "Two patients with longitudinally extensive myelopathy were initially biopsied for suspected spinal cord tumors. Both patients were later diagnosed with neuromyelitis optica spectrum disorders (NMOSD) supported by their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immunohistochemical staining demonstrated findings compatible with acute NMOSD lesions in one case while the other case exhibited findings consistent with chronic NMOSD lesions. A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD.",

keywords = "Neuromyelitis optica, aquaporin-4, biopsy, differential diagnosis, pathology, spinal cord tumor",

author = "Sato, {Douglas Kazutoshi} and Tatsuro Misu and Rocha, {Cristiane Franklin} and Dagoberto Callegaro and Ichiro Nakashima and Masashi Aoki and Kazuo Fujihara and Lana-Peixoto, {Marco Aurelio}",

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T1 - Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors

T2 - Diagnostic considerations

AU - Sato, Douglas Kazutoshi

AU - Misu, Tatsuro

AU - Rocha, Cristiane Franklin

AU - Callegaro, Dagoberto

AU - Nakashima, Ichiro

AU - Aoki, Masashi

AU - Fujihara, Kazuo

AU - Lana-Peixoto, Marco Aurelio

PY - 2014/4

Y1 - 2014/4

N2 - Two patients with longitudinally extensive myelopathy were initially biopsied for suspected spinal cord tumors. Both patients were later diagnosed with neuromyelitis optica spectrum disorders (NMOSD) supported by their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immunohistochemical staining demonstrated findings compatible with acute NMOSD lesions in one case while the other case exhibited findings consistent with chronic NMOSD lesions. A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD.

AB - Two patients with longitudinally extensive myelopathy were initially biopsied for suspected spinal cord tumors. Both patients were later diagnosed with neuromyelitis optica spectrum disorders (NMOSD) supported by their AQP4-seropositivity. Pathological review of both biopsies revealed demyelinated lesions with thickened vessel walls and tissue rarefaction. Immunohistochemical staining demonstrated findings compatible with acute NMOSD lesions in one case while the other case exhibited findings consistent with chronic NMOSD lesions. A pre-biopsy differential diagnosis of longitudinally extensive spinal cord tumors should include NMOSD. Specific biopsy features, such as cystic changes with vascular wall thickening and astrocyte injury, should raise suspicion for NMOSD.

KW - Neuromyelitis optica

KW - aquaporin-4

KW - biopsy

KW - differential diagnosis

KW - pathology

KW - spinal cord tumor

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Aquaporin-4 antibody-positive myelitis initially biopsied for suspected spinal cord tumors: Diagnostic considerations

Abstract

Keywords

ASJC Scopus subject areas

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