PMC5502295_01
(a) CT on admission revealing the dilatation of bilateral ventricles and the bilateral periventricular lucency. (b) Postoperative CT revealing the size of bilateral ventricles was normalized and bilateral periventricular lucency disappeared after ventriculoperitoneal shunts
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F1
Hydrocephalus was diagnosed by computed tomography (CT) [Figure 1a]. Following VP shunt, the size of lateral ventricles became normal [Figure 1b] and the patient discharged without its neurological signs and symptoms on May 10, 2016.
(a) The distal side of the peritoneal catheter is obstructed by a fibrous encapsulating tissue covering it like a long stocking. (b) The fibrous encapsulation covers the intraabdominal peritoneal catheter from the middle part of it to the distal side of it. (c) The fibrous encapsulating tissue disconnects with a fibrous tissue at the orifice of peritoneal cavity. (d) The fibrous encapsulating tissue is about 16cm long and it looks like a long white stocking
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F2
Although obvious obstruction of the peritoneal catheter could not be found by shuntgraphy, laparoscopy-assisted surgery was performed, and the intraabdominal peritoneal catheter was obstructed by a fibrous encapsulating tissue, which covered it like a long stocking [Figure 2a-c]. This encapsulating tissue of the peritoneal catheter was excised by laparoscopy forceps [Figure 2d].
(a) Photomicrograph of the surgical specimen shows fibrous tissue with a few inflammatory cells. And it is covered with a layer of cells suspected to be mesothelium cells (and  ). Hematoxylin and eosin stain, original magnification x200. (b) Immunohistochemical examination revealing that a layer of cells suspected to be mesothelium shows positive staining for calretinin in the current case. Immunohistochemical examination revealing that a layer of lining cells (c) and a few surface cells (and  ) (d) also show positive staining for calretinin in previously reported fibrous capsule cases
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F3
The histopathological diagnosis of this encapsulating tissue was the fibrous tissue with a few inflammation cells [Figure 3a]. Moreover, some parts of this fibrous tissue were surrounded by a layer of lining cells that showed immunohistochemically positive staining for calretinin [Figure 3b].