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Mycobacterial Spindle Cell Pseudotumor of the Spinal Cord: Case Report and Literature Review

Michael Tran Duong, Adam Ungemach,Faizan Malik, Melissa T. Duong, Noah Wasserman,Kumarasen Cooper,Austin R. Pantel, Jessica C. O'Neil,Zsofia Szep

Journal of neuroimmunology(2024)

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摘要
We report the first description of spinal cord mycobacterial spindle cell pseudotumor. A patient with newly diagnosed advanced HIV presented with recent-onset bilateral leg weakness and was found to have a hypermetabolic spinal cord mass on structural and molecular imaging. Biopsy and cultures from blood and cerebrospinal fluid confirmed spindle cell pseudotumor due to Mycobacterium avium-intracellulare. Despite control of HIV and initial reduction in pseudotumor volume on antiretrovirals and antimycobacterials (azithromycin, ethambutol, rifampin/rifabutin), he ultimately experienced progressive leg weakness due to pseudotumor re-expansion. Here, we review literature and discuss multidisciplinary diagnosis, monitoring and management challenges, including immune reconstitution inflammatory syndrome.
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