PMC6332746_01
Immediate postmortem transverse T2-weighted (A), FLAIR (B), and T1-weighted (C) MR images of the cerebellum of a 9-month-old Shorthorn cross heifer showing a large right-sided well-defined smoothly marginated intra-axial mass replacing more than two thirds of the normal cerebellar parenchyma
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T2-weighted, FLAIR, and 3D-constructive interference steady-state sequences, the mass was heterogeneously hyperintense to normal gray matter in the periphery, with an irregular ill-defined markedly hyperintense core (Figure 1A,B). The mass was heterogeneously hypointense to normal gray matter on T1-weighted and 3D-volumetric interpolated breath-hold examination images, with small irregular hyperintense foci in the center (Figure 1C).
Immediate postmortem midsagittal (A) and dorsal (B-level of the dorsal third ventricle; C-level of the mesencephalic aqueduct) T2-weighted MR images of the brain of a 9-month-old Shorthorn cross heifer showing severe mass effect on the thalamus and brainstem associated with the cerebellar mass
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A severe mass effect was present causing obstructive hydrocephalus, and the lateral and third ventricles displayed moderate enlargement (Figure 2) and mild periventricular edema on FLAIR images. Severe dorsoventral compression and left-sided displacement of the brainstem (Figure 2C) and caudo-rostral brain shift with associated rostral transtentorial herniation of the cerebellum were present. One of the mass lobules was also herniating through the foramen magnum (Figure 2A).
A, Unfixed median section of the brain of a 9-month-old heifer revealing a firm, pale cream to yellow, homogeneous and lobulated intra-axial mass in the cerebellum with a central, focal, 1.5 cm ovoid necrotic cavity containing pale to straw yellow colored transparent fluid. B, Photomicrograph demonstrating sheets of moderately densely packed small neoplastic cells. H&E stain; scale bar: 50 mum. C, Immunohistochemically, the majority of neoplastic cells within densely cellular nodular areas of the neoplasm show moderate cytoplasmic staining with NSE. Scale bar: 50 mum. D, Approximately 10% of neoplastic cells showed weak to moderate staining with synaptophysin. Scale bar: 20 mum. H&E, hematoxylin-eosin; NSE, neuron-specific enolase
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On longitudinal sectioning, the normal distinction between gray and white matter at the arborvitae was replaced by a central, focal, 1.5 cm diameter, ovoid defect containing pale to straw yellow transparent fluid, with a small hemorrhagic area in its rostral margin (Figure 3A). Within the mass, there were variably sized poorly demarcated nodules of moderately densely packed small, neoplastic cells arranged in sheets separated by less densely cellular areas supported by neurofibrillary stroma (Figure 3B). Overall, between 30% and 50% of neoplastic cells showed some cytoplasmic staining with neuron-specific enolase (NSE) (Figure 3C). Neoplastic cells did not stain with glial fibrillary acidic protein (GFAP) or chromogranin A, and weak cytoplasmic staining was seen in up to 10% of neoplastic cells with synaptophysin (Figure 3D).