PMC8202384_01
Cranial computed tomography and magnetic resonance imaging revealed a large cortical-based lesion of approximate size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left. The lesion is predominantly cystic, with suppression on fluid-attenuated inversion recovery with a peripherally based heterogeneous mural nodule showing contrast enhancement. (a) Computed tomography scan showing tumor, (b) magnetic resonance imaging axial, (c) magnetic resonance imaging coronal, (d) magnetic resonance imaging sagittal
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F1
Magnetic resonance imaging (MRI) brain and magnetic resonance venography were performed and revealed a large cortical-based intra-axial lesion of size 5.7 cm x 5.3 cm x 4.4 cm in the left frontal lobe, causing a significant midline shift to the left [Figure 1].
Microscopic appearance: Compact tumor in sheet along and tubules abutting adjacent normal brain parenchyma (H and E, x100)
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F2
On microscopy, a tumor of oval cells with moderate eosinophilic cytoplasm, arranged in sheets along with papillae and tubules, was viewed [Figure 2].
Microscopic appearance: Tumor composed of perivascular rosettes and surrounding tumor necrosis (H and E, x200)
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F3
Most of the nuclei were round, with coarse chromatin, and only some had eosinophilic inclusions [Figure 3]. Perivascular pseudorosettes were also seen [Figure 3].
Immunohistochemistry: High Ki67 labeling index indicating increased proliferation of tumor cells (immunohistochemistry; x400)
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F4
Ki67 labeling index was high (approximately 50%), indicating active proliferation of tumor cells [Figure 4].