PMC9944648_01
(a) MRI-T1 weighted MRI of the brain showing a hyperintense lesion of right cerebellar hemisphere with striated folial pattern or tiger-striped appearance, (b) Gross-Enlarged cerebellar folia, (c) (squash cytology, H&E x 400) - scattered, enlarged cells with vesicular nuclei and prominent nucleoli against a fibrillary background, (d) (squash cytology, H&E x 400) - Thickened axons and capillary sized vessels.
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F1
Radiologically, two out of the six cases were suspected to be LDD on magnetic resonance imaging (MRI) [Figure 1a]. [Table 1] shows the clinical, radiological, and histopathological findings of individual cases.
(a) H&E x40, (b) (H&E x100) - Show enlarged cerebellar folia with vacuolation of molecular and granular layer and loss of Purkinje cells, (c) (H&E x100) - aggregates of dysplastic neurons in molecular and granular layer, (d) (H&E x400) - Shows calcified vessel wall and vacuolation in background.
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F2
Histopathology showed thickened and spongy molecular layer with vacuolar change and loss of granular layer and Purkinje cells [Figure 2a and b]. Aggregates and scattered large dysplastic neurons with vesicular nuclei and prominent nucleoli are shown [Figure 2c]. Prominent microvasculature and calcification were seen in two cases [Figure 2d].
(a) (H&E x100) - Shows aggregates of large dysmorphic neurons admixed with dense inflammation predominantly plasma cells, (b) (H&E x400) - show numerous dysplastic ganglion cells.
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F3
A case showed prominent plasma cells amidst the clusters of dysplastic ganglion-like cells [Figure 3a and b].