PMC4238756_01
Axial section from a non-contrast CT of the head showing a well-defined, extra-axial lesion of attenuation of CSF in the suprasellar region extending towards the anterior skull base on the right side. A part of the lesion on the left side shows evidence of increased density.
poljradiol-79-422-g001.jpg
PMC4238756_01_poljradiol-79-422-g001.jpg
f1-poljradiol-79-422
Computed Tomography (CT) of the head was done which showed a well-defined extraaxial mixed density lesion in the suprasellar region (Figure 1).
Axial (A) and sagittal (B) T1-weighted MR images of the brain showing a hypointense signal similar to CSF in major portion of the sellar and suprasellar lesion with a thin septum. A part of the lesion on the left side of the septum shows a hyperintense signal. Coronal post-contrast T1-weighted image (C) of the brain showing non-enhancement in major portion of the lesion with smooth, thin rim enhancement in the left-sided locule.
poljradiol-79-422-g002.jpg
PMC4238756_01_poljradiol-79-422-g002.jpg
f2-poljradiol-79-422
T1-weighted sequence (Figure 2A, 2B) and it was hyperintense on T2-weighted (Figure 3) and FLAIR sequences. There was no evidence of restricted diffusion (Figure 4). T1-weighted images (Figure 2A, 2B). That area also showed smooth, thin, peripheral enhancement, although the rest of the lesion was non-enhancing (Figure 2C).
Axial T2-weighted sequence of MRI showing uniform hyperintense signal within the lesion with a thin septum.
poljradiol-79-422-g003.jpg
PMC4238756_01_poljradiol-79-422-g003.jpg
f3-poljradiol-79-422
T1-weighted sequence (Figure 2A, 2B) and it was hyperintense on T2-weighted (Figure 3) and FLAIR sequences. There was no evidence of restricted diffusion (Figure 4).
Axial diffusion-weighted image showing evidence of increased diffusivity within the lesion.
poljradiol-79-422-g004.jpg
PMC4238756_01_poljradiol-79-422-g004.jpg
f4-poljradiol-79-422
T1-weighted sequence (Figure 2A, 2B) and it was hyperintense on T2-weighted (Figure 3) and FLAIR sequences. There was no evidence of restricted diffusion (Figure 4).
Peroperative photograph showing cyst visible in the inter optic and optico carotid space (A) and straw colored fluid being aspirated (B).
poljradiol-79-422-g005.jpg
PMC4238756_01_poljradiol-79-422-g005.jpg
f5-poljradiol-79-422
Cyst was also punctured at the time of surgery and light straw colored fluid was aspirated (Figure 5A, 5B).
Low power view (100x) (A) and high power view (400x) (B) showing evidence of meningothelial cells within the cyst wall along with fibro-connective tissue. Immunohistochemistry showed positive staining with EMA (epithelial membrane antigen) in meningothelial cells (C) and with Vimentin (D).
poljradiol-79-422-g006.jpg
PMC4238756_01_poljradiol-79-422-g006.jpg
f6-poljradiol-79-422
Histopathology showed the cyst wall lined by meningothelial cells along with fibroconnective tissue (Figure 6A, 6B). Immunohistochemistry showed positive staining with EMA (Figure 6C) and vimentin (Figure 6D).