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A mildly T2 hyperintense, vividly enhancing, extraaxial mass arises from a broad dural base along the anterior wall and floor of right anterior cranial fossa, with mass effect on the right frontal pole and orbital gyri. A small enhancing dural tail extends medially.
Numerous FLAIR hyperintense foci involve the supratentorial white matter, and there is patchy signal abnormality of the brainstem. Appearances are consistent with moderately severe for age microvascular ischemia.
Multiple foci of susceptibility artifact is likely to be secondary to amyloid angiopathy. Ventricles and sulci are within limits for age.
Features are those of a meningioma.
The patient went on to have surgery.
MICROSCOPIC DESCRIPTION: The sections show a moderately cellular meningioma. The tumor forms whorls and fascicles. The tumor cells have ovoid nuclei with no nuclear pleomorphism. The background shows many blood vessels of varying sizes. They have marked intimal hyperplasia. Mitotic figures are inconspicuous. Necrosis is absent. There is no brain parenchyma included in the biopsy. No evidence of atypical or malignant change is identified.
FINAL DIAGNOSIS: Angiomatous meningioma (WHO grade I).