Acute spontaneous thoracic epidural hematoma associated with intraspinal lymphangioma: A case report

Figure 1 Hematoxylin and eosin staining. A: Proliferation of irregular thick wall vascular channels lined by flat endothelial cells with clear lymphatic fluid in the lumens [hematoxylin and eosin (H&E), 40 ×]; B: Some of the proliferative vessels are filled with blood, instead of lymphatic substance (H&E, 100 ×).

Figure 2 Preoperative spinal magnetic resonance imaging demonstrating an intraspinal epidural hematoma at the T4 to the T8 levels (arrows). A: Sagittal T1-weighted image (T1WI); B: Sagittal T2-weighted image; C: Sagittal T1WI with enhancement showing mildly thin peripheral enhancement (arrowheads) and the spinal cord is compressed and flattened (dashed thin arrows).

Figure 3 Dark reddish blood (arrows) in the epidural space was exposed after a laminectomy.

Figure 4 After a laminectomy of T5, numerous epidural vessels (arrowheads) were found.

Figure 5 Postoperative spinal angiography shows the artery of Adamkiewicz arising from the right radiculomedullary artery at T10 level.

Figure 6 Postoperative spinal magnetic resonance imaging revealing a faint T2 hyperintense intramedullary signal at the T6-T8 levels (arrow heads) with no residual epidural hematoma and no remaining spinal cord compression. A: Sagittal T1-weighted image; B: Sagittal T2-weighted image.