Brain Stem Lesion MRI

MRI BRAIN WITH CONTRAST, WHOLE SPINE SCREENING REPORT

Multi planner multi echo MRI study of brain has been performed. Sequences planned are FSE T1W, FSE T2W, FLAIR, T2w *GRE and DW images. Pc T1 

This MRI study of Brain with whole spine shows:

1. An ~ 25x27mm intral axial cystic lesion with an avidly enhancing eccentric nodule, lesion causing marked expansion of medulla, marked peri lesional odema extending in adjacent Pons. Obstruction at the level of outlet foramen of fourth ventricle causing mild communicating hydrocephalus. 

2. An associated severe cervico dorsal cord syrinx.

3. Avidly enhancing nodule of spinal drop metastasis at D7-8 and D11.

Imaging wise Possible DDs given were Neoplastic_ like Medullary Pilocystic Astrocytoma, Hemangioblastoma. 

FOLLOW UP

Posterior fossa craniotomy with excision of lesion.

Histopathology report

Gross : The specimen consist of single nodular piece of gray white tissue, measuring 2x2x2cm. 

Microscopy: 

Sections shows moderately vascular neoplasm of both cellular and reticular areas comprising numerus proliferating vascular channels of varying caliber few of them appear to congested. The interstitium shows scattered round to oval cells having modestly hyperchromatic nuclei with coarse chromatin and abundant eosiophillic to vacuolated cytoplasm. These cells have indinct cytoplasmic margins. No atypical mitosis nor tumor necrosis seen. 

Impression :

Histopathological diagnosis : Hemangioblastoma.