PMC5987328_01
T1-weighted Gd-MRI, axial image. x: symmetrical lineal diffuse thickening and enhancement of the dural layer of the IAC. i: left labyrinthine and tympanic facial nerve enhancement.
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fig1
We found in the T1-weighted, gadolinium-enhanced magnetic resonance imaging (Gd-MRI) diffuse dural and symmetrical enhancement of the dural layer of the posterior and middle fossae including the convexity and surprisingly the dural layer of the internal auditory canal (IAC) and the left labyrinthine and tympanic facial nerve (Figure 1).
Dura (haematoxylin and Eosin). Arrow: multinucleated giant cells associated with the small caliber vessel wall. Arrow: severe mononuclear infiltrate.
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fig2
The last finding could be proposed to be considered as pathognomonic sign of GPA (Figure 2).