PMC8432387_01
Brain magnetic resonance imaging (MRI). A - T1 axillary post-contrast images demonstrate a closely associated mass located parasagittal along the superior portion of the right tentorium and measuring 3.3 x 2.1 x 1.9 cm. Note the mass effect on the right occipital lobe; B - The T1 axial post-contrast shows that the enhancing lesion spans the midline within the posterior fossa and appears based within the tentorium and measures 4.5 x 6.1 x 1.8 cm; C - The sagittal; and D - axial post-contrast T1 isointense shows a heterogeneously enhancing mass of the tectum/pineal gland region, which measures 2.3 x 2.2 x 2.5 cm with pressure effect on the cerebellar hemispheres and tonsillar herniation of approximately 1.8 cm inferior to the cisterna magna.
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Magnetic resonance imaging (MRI) with and without IV contrast showed multiple heterogeneous intracranial masses with resultant mass effect compressing the cerebral aqueduct with dilation of the 3rd and 4th ventricles hydrocephalus and tonsillar herniation (Figure 1).
Photomicrographs of the surgical specimen. A and B - Cerebellar tissue infiltrated by a diffuse proliferation of foamy histiocytes and spindle cells mixed with prominent lymphoplasmacytic infiltrate (H&E, A 40X, and B 100X); C - foamy histiocytes and spindle cells (H&E, 400X); D - Positive immunoreaction for CD163.
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Biopsy results from the cerebellar mass demonstrated cerebellar tissue involved by a diffuse proliferation of foamy histiocytes and spindle cells admixed with prominent lymphoplasmacytic infiltrate (Figure 2).
Bone scan shows high-intensity trace uptake in the skull, mandible, predominantly distal long bones of the upper and lower extremities are consistent with widespread histiocytosis.
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Bone scan showed high-intensity trace uptake in the skull, mandible, predominantly distal long bones of the upper and lower extremities is consistent with widespread histiocytosis (Figure 3).