PMC4899808_01
75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. Axial unenhanced CT image shows a well-circumscribed, expansive lytic lesion within the right angle and body of the mandible, with cortical expansion and incomplete internal septa but without internal osteoid or calcified matrix.
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A CT scan (Fig. 1) showed a well-circumscribed and expansive lytic lesion.
75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. MR imaging (1.5T scanners, Symphony and Avanto; Siemens, Erlangen, Germany) confirms a well-defined expansive lesion with homogeneously low signal intensity on T2-weighted turbo spin-echo images without fat saturation (TR/TE _ 521/10 msec).
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MRI demonstrated low signal intensity on T1- and T2- weighted images (Fig. 2), heterogeneous contrast enhancement (Fig. 3), and marked loss of signal intensity on T2 gradient-echo images (blooming effect) consistent with magnetic susceptibility (Fig. 4).
75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. The lesion has decreased signal intensity on T2-weighted gradient-echo sequence (TR/TE _ 890/26 msec). Magnetic susceptibility with significantly low signal intensity is caused by hemosiderin deposition.
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MRI demonstrated low signal intensity on T1- and T2- weighted images (Fig. 2), heterogeneous contrast enhancement (Fig. 3), and marked loss of signal intensity on T2 gradient-echo images (blooming effect) consistent with magnetic susceptibility (Fig. 4).
75-year-old woman with right mandible cystic lesion and primary hyperparathyroidism. H&E staining shows multinucleated giant cells and abundant hemosiderin deposition.
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Subsequently, after an open biopsy of the mandible lesion, histology revealed giant-cell granuloma and hemosiderin deposition (Fig. 5), consistent with mandible "brown tumor."