PMC4134350_01
(a) Non-contrast head CT revealing a 1.4-cm pineal region mass with embedded pineal calcifications. (b) MRI imaging revealing a 1.0 x 1.4 cm2 T1 hypodense lesion with heterogenous gadolinium contrast and T2 prolongation
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F1
This lesion was embedded with apparent pineal calcifications, but heterogeneous portions of this mass were not calcified (Fig. 1). This lesion exhibited heterogeneous hypointensity on T1-weighted and prolongation on T2-weighted images, and heterogeneous contrast enhancement with gadolinium administration, without hydrocephalus (Fig. 1).
(a) Hematoxylin and eosin staining demonstrating areas of well circumscribed, compact granulomas (100x) with (b) No necrosis within pineal gland (200x). (c) Immunohistochemistry for synaptophysin demonstrating negative granulomas within synaptophysin positive pineal gland (100x). (d) Immunohistochemistry for CD68 demonstrating well-circumscribed, non-necrotic CD68 positive granulomas within pineal gland (100x)
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F2
Immunohistochemistry with synaptophysin, CD68, CD3, and CD20 were performed to confirm the histologic diagnosis (Fig. 2). The synaptophysin was positive in the background, indicating pineal gland tissue (Fig. 2c).