PMC4242059_01
Cranial MRI: T1 post-contrast image in axial view: Enhancing parenchymal nodule involving the left temporal lobe, the lenticular nucleus and the internal capsule
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A follow-up Magnetic resonance neuro-imaging studies (MRI), with and without contrast, identified a left temporal globular mass involving the lenticular nucleus and the internal capsule with edema and signal intensities suggestive of glial neoplasm (Figure 1, Figure 2).
Cranial MRI: T2 image in coronal view: Nodule with surrounding edema
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A follow-up Magnetic resonance neuro-imaging studies (MRI), with and without contrast, identified a left temporal globular mass involving the lenticular nucleus and the internal capsule with edema and signal intensities suggestive of glial neoplasm (Figure 1, Figure 2).
Granulomatous process involving neuroglial tissue (H&E x40)
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Pathological examination revealed neuroglial tissue heavily involved with multiple granulomas (Figure 3).
Nectrotising Granuloma with a central region of necrosis (H&E x 100)
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These lesions consisted of focal areas of fibrinoid necrosis, surrounded by a rim of mononuclear cells (Figure 4).
Granuloma with epithlioid cells and lymphocytes (H&E x200)
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Most cells also had a generous amount of pink cytoplasm (epithelioid cells) (Figure 5).
Masson trichrome staining highlighting Fibrosis surrouding granulomas (TM x 40)
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Trichrome staining (Figure 6). There was no definitive vasculitis, although some vessels had inflammatory cells around them.