PMC4533475_01
a: Initial T1-weighted magnetic resonance imaging with gadolinium. Well-enhanced nodules at bilateral foramen Lushka. b: The largest calcified mass in cerebello-pontine cistern showing mass effect. c: Coronal view showing enhanced lesions in the floor of third ventricle and adjacent to the left hippocampus. d: Sagittal section showing abnormal enhancement in the floor and posterior wall of third ventricle.
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F1
Magnetic resonance (MR) imaging showed multiple intracranial masses and they were strongly enhanced with contrast medium (Fig. 1a-d).
Photomicrograph showing necrosis surrounded by epithelioid cells (a) with few multinucleated giant cells (b). Hematoxylin and eosin stain.
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F2
The surgical specimens histologically consisted of coagulative necrosis surrounded by epithelioid cell granulomas with a few multinucleated giant cells including Langhans-type (Fig. 2a, b).
T1-weighted magnetic resonance imaging with gadolinium enhancement taken one month after the biopsy. All the masses remarkably reducing in size (a, b).
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F3
The masses continued to shrink for the next 6 months (Fig. 3a, b) as observed under MR imaging.
Magnetic resonance (MR) imaging taken 9 months after the biopsy showing the recurrence of the masses. T2-weighted MR imaging showing remarkable high intensity in bilateral peduncle and thalamus (a, b). T1-weighted MR imaging showing regrowth of the pre-existed masses (c, d).
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F4
MR imaging showed regrowth of the masses (Fig. 4a-d).
Final magnetic resonance (MR) imaging after steroid therapy. a: T1-weighted MR imaging with gadolinium enhancement showing minimal enhancement of the choroid plexus and b, c: disappearance of abnormal enhancement of the cerebellopontine angle and third ventricle.
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F5
The lesions kept shrinking and the granulomas almost disappeared except calcification in 3 years (Fig. 5a-c).