PMC9168290_01
(a) Ill-defined, expansile, T1 isointense, (b) T2 hyperintense, (c) Nonenhancing lesion within the left amygdala and hippocampus with blurring of the gray-white junction in the adjacent anteromedial temporal lobe (arrows). (d) Perfusion imaging demonstrates relative decrease in cerebral blood flow in the left temporal lobe.
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F1
T1 isointense, T2/FLAIR hyperintense, nonenhancing mass lesion with blurring of the gray matter- white matter junction centered in the left amygdala with arterial spin-labeled perfusion imaging demonstrating decreased relative cerebral blood flow/hypoperfusion in the left temporal lobe [Figure 1]. The initial imaging diagnosis was a focal cortical dysplasia with an associated glioneuronal tumor.
H&E images (at various magnifications) showing a cluster of oligodendrocytes with round nuclei and cytoplasmic clearings (arrows) in the subcortical white matter. Neurons with larger nuclei (relative to oligodendrocytes) can be seen in the adjacent cortex.
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F2
Pathology revealed an oligodendroglial hamartoma [Figure 2].
(a) Status-post left anterior temporal lobectomy and left amygdalohippocampectomy with expected postsurgical changes. New ill-defined T1 isointense, (b) T2 FLAIR hyperintense, (c) and nonenhancing lesion in the right amygdala with blurring of the gray-white junction in the right inferomedial temporal lobe (arrows).
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F3
Repeat MR imaging demonstrated a new ill-defined lesion within the right amygdala with similar characteristics as the previously resected left amygdala oligodendroglial hamartoma [Figure 3].
(a) Preoperative imaging demonstrating subtle, ill-defined T2 hyperintense lesion within the right amygdala, (b) which appears increased in constituency on postsurgical T2 FLAIR (arrows).
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F4
Retrospectively, the right-sided lesion was subtle but noticeable in prior imaging studies including preoperative MR imaging [Figure 4].