PMC10203496_01
MRI shows a focal mass located in the posterior left cerebellum parenchyma. (A, B) Contrast-enhanced (A) axial and (B) sagittal T1-weighted images. (C) T2-weighted image showed similar intensity between the mass and cerebrospinal fluid.
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F1
MRI examination revealed intra-axial masses on the left cerebellar parenchyma with a well-defined and contrast-enhanced border (Figures 1A-C).
Intraoperative view. The cystic contains bursting out through the corticotomy side due to high pressure.
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F2
A yellowish liquid appears on the inside of the mass and due to high intracranial pressure the cystic contain burst out through the corticotomy side (Figure 2).
Microscopic view. (A) The tumor mass (black arrow), surrounded by cerebellar tissue (arrowhead) (HE stain; 40 x magnifications). (B) Branching and dilating large capillaries (black arrow) with small capillaries (arrowhead) (HE stain; 100 x magnifications). (C) The blood vessels form a lobulated structure (black arrow), surrounded by cerebellar tissue (arrowhead) (HE stain; 100 x magnifications). (D) The blood vessels are lined by a layer of flat-plump endothelial cells (black arrow) (HE stain; 400 x magnifications).
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F3
On microscopic cross-sections, the mass appears to be well-defined with the surrounding tissue without being covered by a capsule (Figure 3A). The mass is formed by the proliferation of capillaries, which are lined by a layer of flat-plump endothelial cells with some of the lumen filled with erythrocytes (Figure 3D. These blood vessels form a lobulated structure that varies, where each part is separated by fibro collagenous connective tissue (Figure 3C). There are some large capillaries, following the description of the parent vessels, where branching and dilatation are visible (Figure 3B.
The IHC results with S100 show positive results on the stromal cells (white arrow) but negative on endothelial cells (400 x magnifications) (left). The CD31 shows positive results on the endothelial cells (black arrow) (400 x magnifications) (right).
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F4
It reveals positive CD31 on the endothelial cells and S100 on the stromal cells with negative S100 on the endothelial cells (Figure 4).