Thursday, 26 January 2012

Sphenoid wing Meningioma MRI

MRI Brain Axial T2, T1 and Post contrast T1.
Axial T1 and T2w MRI sections show an extra axial dura based solid signal intensity mass, overlying lateral sphenoid wing, homogenously iso intense to cortical grey matter on T1 and T2w images, intense homogenous enhancement on post contrast T1 with dural tailing.
Marked peri lesional Odema in adjacent compressed left frontal lobe parenchyma.
An associated adjacent meningeal cyst in left sylvian fissure.

Significant mass effect as mid brain is compressed.

On single voxel MR Spectroscopy,
At 1.3ppm Peaks of Alanine which is very typical for meningioma.
Absence of NAA at 2 ppm implies to Non neuronal neoplasm with high choline at 3.2ppm.

Imagingwise diagnosis : Sphenoid wing Meningioma. 

Histopathological report : Meningioma (Transitional – psammomatous variant).
Gross Appearance : Dull – grey tan tissue with friable appearance.
Microscopy : : Benign neoplasm of probable meningothelial cell origin. It comprise moderately cellular, largely patternless or sheet - like growth of intermediate sized, round to oval cells having modestly hyperchromatic nuclei with round to oval configuration and having delicate - peripherally condensed chromatin and many cells having small nucleoli. Overall scattered cells show nucleoli - cytoplasmic invaginations. The cells have faint eosinophilic cytoplasm with indistinct margins. Few foci show vague lobularity and occasional mitotic figure. Many scattered foci show psammomatous calcific spherules. The scanty interstitium shows entrapped congested blood vessels. 

Other similar cases : Meningioma

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