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Print ISSN: 1792-0981 Online ISSN: 1792-1015
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May-2026 Volume 31 Issue 5

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Case Report

Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report

  • Authors:
    • Yajun Yao
    • Ge-Hong Dong
    • De-Cai Tian
  • View Affiliations / Copyright

    Affiliations: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P.R. China, Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, P.R. China
  • Article Number: 129
    |
    Published online on: March 6, 2026
       https://doi.org/10.3892/etm.2026.13124
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Abstract

The present case report describes a 31‑year‑old male patient with isolated spinal vasculitis. The patient initially presented with right‑hand numbness and weakness, which later extended to both lower limbs, causing gait instability. MRI scans performed after the symptoms had extended to both lower limbs revealed a cervical lesion with T1 hypointensity, T2 hyperintensity and heterogeneous enhancement, initially suspected to be a tumor. Histopathological analysis of the spinal cord biopsy specimen revealed lymphocytic infiltration surrounding the small vessels of spinal cord, supporting a diagnosis of primary isolated spinal vasculitis. The patient was treated with high‑dose intravenous methylprednisolone for 9 days (500 mg for 3 days, 250 mg for 3 days and 120 mg for 3 days), resulting in pronounced clinical improvement on follow‑up neurological examination and no recurrence at the 2‑year follow‑up without additional immunosuppressive therapy. The present case underscores the diagnostic challenge of distinguishing vasculitis from spinal tumors and highlights the uncertainty regarding long‑term recurrence prevention strategies.
View Figures

Figure 1

Cervical lesions detected through MRI
scans and pathological findings. (A) Serial cervical spine MRI
findings. (a-1) Baseline MRI demonstrated a longitudinally
extensive intramedullary lesion with cord swelling on T2-weighted
images and heterogeneous enhancement on post-contrast T1-weighted
images (arrows). (a-2) Immediate postoperative MRI showed
persistent intramedullary signal abnormality with residual
enhancement (arrows). (a-3) Follow-up MRI after high-dose
corticosteroid therapy showed interval reduction of the lesion and
no residual enhancement (arrows). (B) H&E staining showing
vasculocentric lymphocytic infiltration involving small vessel
walls, consistent with small-vessel vasculitis.
Immunohistochemistry showed CD3+, CD20+,
CD68+, α-SMA+, CD34+,
GFAP+, NF+, MBP+,
Olig-2-, OCT4-, H3K27me3+,
EZHIP-, SALL4-, H3K27M- and
Ki-67+ (scattered) staining, supporting small-vessel
vasculitis and arguing against a neoplastic process. Scale bar, 200
µm. α-SMA, α-smooth muscle actin; GFAP, glial fibrillary acidic
protein; NF, neurofilament; MBP, myelin basic protein; Olig2,
oligodendrocyte transcription factor 2; EZHIP, enhancer of zeste
inhibitory protein; SALL4, Spalt-like transcription factor 4;
H3K27M, histone H3 (mutated K27M); H3K27me3, histone H3 (tri methyl
K27); C, contrast-enhanced.
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Copy and paste a formatted citation
Spandidos Publications style
Yao Y, Dong G and Tian D: Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report. Exp Ther Med 31: 129, 2026.
APA
Yao, Y., Dong, G., & Tian, D. (2026). Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report. Experimental and Therapeutic Medicine, 31, 129. https://doi.org/10.3892/etm.2026.13124
MLA
Yao, Y., Dong, G., Tian, D."Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 129.
Chicago
Yao, Y., Dong, G., Tian, D."Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 129. https://doi.org/10.3892/etm.2026.13124
Copy and paste a formatted citation
x
Spandidos Publications style
Yao Y, Dong G and Tian D: Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report. Exp Ther Med 31: 129, 2026.
APA
Yao, Y., Dong, G., & Tian, D. (2026). Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report. Experimental and Therapeutic Medicine, 31, 129. https://doi.org/10.3892/etm.2026.13124
MLA
Yao, Y., Dong, G., Tian, D."Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 129.
Chicago
Yao, Y., Dong, G., Tian, D."Diagnostic and therapeutic challenges of isolated spinal vasculitis: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 129. https://doi.org/10.3892/etm.2026.13124
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