PMC9633983_01
Non-contrast computed tomography (CT) shows that the masses with slight hyper-attenuation were in the third ventricle (the tumor size: 22 mm x 22 mm x 15 mm, CT value: 47HU) (arrow), in the body (not shown) and posterior horn (arrowhead) of the left lateral ventricle.
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F1
The biggest one was located in the third ventricle and the others were located in the body and posterior horn of the left lateral ventricle (Figure 1), MRI showed multifocal solid lesions in the same regions.
Brain magnetic resonance imaging (MRI). (A-C) Axial T1-weighted imaging (T1WI) (A) shows that the masses with slight hypointensity are in the third ventricle (arrow) and the posterior horn of the left lateral ventricle. Both of them are significantly enhanced on axial (B) and sagittal (C) T1WI with contrast. (D-F) T2-weighted imaging (T2WI) (D) shows the isointense to slightly hypointense masses (arrows), the swollen and hyperintense parenchyma around the third ventricle (arrowheads). Diffusion-weighted imaging (DWI) (E) shows a hypointense mass in the third ventricle (arrow) and a slightly hyperintense mass in the lateral ventricle (arrowhead), both of them with low apparent diffusion coefficient (ADC) value (ADC value: 0.425 x 103mm2/s, 0.628 x 103mm2/s) (F, arrow), all suggesting diffusion restricted.
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F2
It did not cause ventricular expansion and hydrocephalus above the lesions (Figures 2A-F).
Immunohistochemistry of the third ventricular lesion reveals: CD10 (+), CD20 (+), MUM-1 (+), Bcl-2 (+, 90%), Bcl-6 (+), C-myc (+, 10%), Ki-67 (+, 80%), ALK (-), CD3 (-), CD30 (-), cyclin D1 (-), EBER (-), and P53 (wild-type expression).
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F3
Immunohistochemistry revealed the tumor cells were positive for CD10, CD20, Bcl-6, MUM-1, C-MYC(10%), Bcl-2(90%), and Ki-67(80%), and negative for CD3, CD30, cyclin D1, ALK, and EBER in situ hybridization (Figure 3).