PMC7552429_01
Preoperative MR images showing the intraventricular tumor (with yellow asterisk). (A) T2-weighted image, sagittal plane. (B) T1-weighted postcontrast image, sagittal plane. (C) T1-weighted image, transverse plane. (D) T1-weighted image, dorsal plane.
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F1
The optic nerves with their surroundings and the cerebellum were normal (Figure 1).
Anatomical demonstration (A,B) and intraoperative images (C,D) showing the transcallosal approach. The blue circle shows the site, whilst the blue arrow shows the direction of the approach. (1) Corpus callosum. (2) Gyrus marginalis. (3) Gyrus ectomarginalis. (4) Gyrus postcruciatus. (5) Hippocampus. (6) Plexus chorioideus. (7) Nucleus caudatus dexter. (8) Falx cerebri. (9) Nucleus caudatus sinister. (10) Corpus fornicis.
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F2
The marginal and ectomarginal gyrus were bluntly dissected, and the gyri (including the cingulate gyrus) was held away with brain spatulas to maintain the field of view (Figure 2).
Postoperative MR images after the removal of the tumor, at the same levels as in Figure 1. (A) T2-weighted image, sagittal plane. (B) T1-weighted postcontrast image, sagittal plane. (C) T1-weighted image, transverse plane. (D) T1-weighted image, dorsal plane.
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F3
T1- and T2-weighted sequences, ventral to the pars centralis of the lateral ventricles, the well-circumscribed hyperintense areas with a hypointense rim on the T2-weighted sequences were most likely late subacute hemorrhages. The cerebellum was normal (Figure 3).
Histological sections from the intraventricular tumor. (A) Microscopic picture about the tumor which consisted of papillae lined by a single layer of cuboidal or columnar epithelium (Haematoxylin and eosin stain, 400x). (B) Lymphocytic reactivation, multifocal microcalcification and vasodilatation int he stroma of the tumor (Haematoxylin and eosin stain, 400x). (C) Diffuse, intense, pancytokeratin-positivity in the benign neoplastic epithelial cells of the choroid plexus papilloma (IHC, 400x).
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F4
Histopathologic examination showed fronds of the differentiated fibrovascular tissue covered by one layer of uniform cuboidal and columnar epithelial cells (Figure 4A). Multifocal microcalcification and xanthoma production, furthermore focal lymphocytic reactivation, were detected in the stroma of the tumor (Figure 4B). The epithelial cells showed intense, diffuse, homogeneous cytoplasmatic-pancytokeratin-positivity (Figure 4C).