PMC6423896_01
Preoperative MRI showing a wide range of long T1 and T2 signals in the left temporal, occipital, and insular lobes and diffusion-weighted imaging (DWI) demonstrating restricted diffusion in the same area as well as a right quasi-circular ring-enhancement after gadolinium administration (A). A follow-up MRI 5 months after surgery demonstrated basically stable changes (B). Eight months later, the extended range of edema became more apparent. Enhancement of the frontotemporal lobe was visible at the surgical site (C). The range of edema and degree of enhancement were obviously reduced after 1 month of therapy (D).
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F1
II enlargement of the cervical lymph nodes. Initial MRI and diffusion-weighted imaging (DWI) showed temporal and occipital lobe inflammation and colloid cysts in the right lateral ventricular trigone (Figure 1).
Compared with the right basal ganglia region as a normal control area, the NAA peak and NAA/Cr ratio in the pathological area of the left lateral ventricle trigone region were reduced, and the Cho peak and Cho/Cr ratio were increased.
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F2
MR spectroscopy (MRS) demonstrated an obvious rise in choline (Cho) and a decrease in N-acetyl aspartate (NAA) in the left lateral ventricular trigone, indicating the possibility of a tumor lesion (Figure 2).
HE staining (A,B). Pathological examination of the lesion revealed large quantities of histiocytes, lymphocytes, foam-like macrophages, perivascular lymphoid sheath ( ), and infiltration of eosinophils ( ). Neuraxon is clear in NF staining. Immunohistology showing the following: CD68(+), MBP(-), GFAP(+), S-100(+), NF(-), ki-67(10-20%) (C,H). Original magnification x 10 (A,F-H) and x 20 (B-E).
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F3
The MIB-1(ki-67) proliferation was approximately 10-20% (Figure 3).
HLA alleles and altered SNPs in the present case.
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F4
The SNPs in this patient were compared with those reported in the previous literature (Figure 4).