PMC6417329_01
(a) Noncontrast computed tomography head showing large hyperdense extra-axial lesion over midline frontoparietal region. (b) Noncontrast computed tomography head (bone window) showing erosion of the skull
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F1
Noncontrast computed tomography (CT) head done showed a large extra-axial swelling of size 10.3 cm x 8 cm x 7 cm over midline (left > right) frontoparietal parasagittal region causing compression of underlying brain and erosion of skull [Figure 1].
(a) Magnetic resonance imaging showing an isointense tumor on T1-weighted sequence. (b) Magnetic resonance imaging axial view showing a hyperintense tumor on T2-weighted sequence. (c) Contrast-enhanced magnetic resonance imaging (coronal) showing heterogeneously enhancing tumor (with appearance suggestive of sulci and gyri: mini-brain appearance; see inset for illustration). (d) Contrast-enhanced magnetic resonance imaging (sagittal) showing heterogeneously enhancing tumor (with appearance suggestive of sulci and gyri: mini-brain appearance; see inset for illustration)
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F2
Magnetic resonance imaging (MRI) brain [Figure 2] revealed a large heterogeneously enhancing lesion over midline (left > right) frontoparietal parasagittal region.
On magnetic resonance venogram, middle part of superior sagittal sinus was not visualized
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F3
On magnetic resonance venogram [Figure 3], the middle part of the superior sagittal sinus was not visualized.
(a) Low-power microscopy (H and E, x20) showing a cellular tumor lying in sheets. Tumor is seen breaching the bone (arrow). (b) High-power microscopy (H and E, x40) showing plasmacytoid cells with atypical and binucleate forms. (c) Immunohistochemistry showing diffuse positivity for lambda light chain and absence of kappa chain (light chain restriction)
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F4
Histopathology [Figure 4] revealed a tumor with sheets of plasmacytoid cells with large areas of necrosis and microabscesses.