Hypertrophic Pachymeningitis in Chinese Patients: Presentation, Radiological Findings, and Clinical Course

Figure 3

IgG4-related hypertrophic pachymeningitis involving the spinal dura mater (Case 8). Diffuse linear dural enhancement appears on axial (a) and coronal (b) T1-contrasted MRI. Sagittal (c) and axial (d) T1-contrasted MRI show dural thickening of the upper thoracic spinal dura mater. Pathologic slide of biopsy shows dense fibrosis and inflammatory cell infiltration (H&E 100×, (e)), with an increased percentage of IgG4-positive plasma cells (IgG4-IHC 100×, (f)). The dural enhancement is markedly reduced after steroid and immunosuppressive therapy (mycophenolate mofetil) on 4 mouths follow-up (g).

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