PMC8769455_01
Preoperative imaging findings. Non-enhanced CT showed high-density mass lesion in her left frontal lobe with inhomogeneous calcification (A). MRI showed iso- to low-intensity T1-weighted (B), low T2-weighted signal intensity (C), low DWI intensity (D), low SWI intensity (E). Postcontrast T1 showed poor enhancement (F). CT: computed tomography, DWI: diffusion-weighted imaging, MRI: magnetic resonance imaging, SWI: susceptibility- weighted imaging.
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F1
The examination revealed a high-density left frontal lobe mass measuring 1.0 cm x 0.9 cm x 1.2 cm with inhomogeneous calcification (Fig. 1A). Magnetic resonance imaging (MRI) showed a cortical mass with iso- to low signal intensity on T1-weighted imaging (Fig. 1B), low intensity on T2-weighted imaging (Fig. 1C), low intensity on diffusion-weighted imaging (Fig. 1D), low intensity on susceptibility-weighted imaging (Fig. 1E), and little gadolinium enhancement (Fig. 1F).
Intraoperative and histopathological findings. Tumor was white and hard, with well-demarcated margins (A). Hematoxylin and eosin staining 40x low-power view (B) and 200x high-power view (C) showed it was comprised of eosinophilic material and less cellar component. EVG stain showed elastic fiber (D). DFS stain was positive in the eosinophilic material (E) with apple-green birefringence under polarized light microscopy (F). DFS: direct fast scarlet.
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F2
We performed an en bloc resection of the tumor, which was white, hard, and non-hemorrhagic with well-demarcated margins (Fig. 2A). Histological examination of the tumor showed an eosinophilic material component and another less cellular one (Fig. 2B and 2C). Verhoeff's elastic stain showed elastic fibers (Fig. 2D). Direct fast scarlet (DFS) stain was positive for eosinophilic material with apple-green birefringence under polarized light microscopy, which indicated amyloid deposition (Fig. 2E and 2F).