Imaging findings of cryptococcal infection of the thoracic spine

• Cryptococcal spinal infections can be identified in manifestations as vertebral infections, such as destruction of contiguous vertebrae bodies and endplates and extensions of paraspinal soft tissues,
• Cryptococcal spinal infections can also be identified in manifestations as vertebral tumors such as erosions and lytic lesions of vertebrae bodies, simultaneously together, with active blood flow in the intact intervertebral disks.
• A biopsy and fungal cultures are necessary to confirm the diagnosis.

SummaryCryptococcosis 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.