MRI BRAIN WITH CONTRAST REPORT
Left frontal well defined ovoid lesion, major portion of lesion is cystic measures ~ 75x45mm with thin enhancing wall, an ~ 23x25mm eccentric avidly enhancing mural nodule within the lesion, marked peri lesional vasogenic odema. Mass effect, mid line shift of ~ 15mm to right, sub falcine herniation, mild mid brain compression.
Imaging wise DDs: Neoplastic Primary Glioma, Metastasis.
REPORT OF HISTOPATHOLOGICAL EXAMINATION
Specimen : Excisional biopsy – Left frontal lobe SOL.
Gross Appearance : The specimen consists of multiple, irregular, soft to friable pieces of dull grey – tan tissue; together measuring 4.0X3.3X2.0 cm. The cut section shows dull grey tan appearance. Representative sections are submitted for processing. Codes : A and B.
Microscopy : Sections A and B both show cellular meningothelial neoplasm. It comprise lobules and sheets of intermediate sized, round to oval cells having modestly hyperchromatic nuclei with round to oval configuration and having delicate – peripherally condensed chromatin and many cells having small nucleoli. Overall scattered cells show nucleoli – cytoplasmic invaginations. The cells have faint eosinophilic cytoplasm with indistinct margins. The interstitium shows prominent congested vasculature with scattered few lymphocytes. Overall the entire tumour shows 0 – 2 mitosis per 10 HPF. There is no evidence of frank cytological anaplasia nor of brain invasion.
Diagnosis : Meningioma; grade I of III.
Adv. : Ancillary IHC studies for confirmation and definite lineage typing.
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