PMC7074522_01
MRI of the brain. (a) Transverse T2-weighted image (WI) transverse MRI; (b) transverse T1-weighted image (T1WI) precontrast; and (c) transverse T1WI postcontrast
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The mass was ovoid with a regular, distinct margin, and it presented as iso- to hyperintense heterogeneous signal in the brain parenchyma on transverse T2-weighted images (T2WI), and hypointense, homogeneous signal in the brain parenchyma on transverse T1-weighted images (T1WI) (Figure 1a,b). Postcontrast T1WI indicated that the mass, measuring 1.3 x 1.5 x 2.5 cm, was homogenous (Figure 1c) and compressed the left lateral ventricle and thalamus.
Conventional white light and corresponding protoporphyrin IX fluorescence images. (a,b) Intraoperative images of the brain surface after craniotomy. (c,d) Intraoperative photograph at the moment of removal of the mass. (e,f) The resected mass. (a,c,e) White images; (b,d,f) fluorescence images. White arrows show the skull. White arrowheads show meningioma. Yellow arrowheads show the normal brain
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Visual analysis revealed bright red fluorescence of PpIX induced by 5-ALA (Figure 2).
Fluorescence spectrum. The ratio of autofluorescence (505 nm) to protoporphyrin IX fluorescence (635 nm) was 4.26
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A peak of PpIX was observed at 635 nm, and the ratio of autofluorescence (505 nm) to PpIX fluorescence (635 nm) was 4.26 (Figure 3).
Histopathological image of the mass. Histopathological examination (haematoxylin and eosin staining) of the resected mass revealed neoplastic proliferation of spindle eosinophilic cells resembling meningeal epithelium and/or fibroblastic cells, and which were frequently arranged in concentric patterns with occasional calcification at the centre (psammoma body); scale bar = 50 mum
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Histopathological examination of the removed tumour tissue by haematoxylin and eosin staining showed neoplastic proliferation of spindle eosinophilic cells, which resembled meningeal epithelium and/or fibroblastic cells (Figure 4).