Presentation
Headache and seizures.
Patient Data
Left frontoparietal extra-axial well defined hyperdense space occupying lesion. It's surrounded by vasogenic edema.
Left frontoparietal extra-axial space occupying lesion which elicits isointense/slightly hyperintense signal at T1 WI and low signal at T2 WI with intense homogeneous postcontrast enhancement. It's associated with peritumoral cyst and extensive vasogenic edema.
Lymphoplasmacyte-rich meningioma
Case Discussion
Lymphoplasmacyte-rich meningiomas are rare histological variants of benign (WHO grade I) meningiomas, characterized by prominent lymphoplasmacytic infiltrates into the tumor, sometimes rendering the underlying meningothelial component inconspicuous.
Clinical features include a predilection for relatively young patients, often with secondary hypergammaglobulinemia and anemia.
Typically, the tumor is hyperdense on noncontrast CT and iso- to hypointense on T1-weighted images. T2-weighted images show mixed hyper- to iso-intensity more often than iso- to hypointensity. Diffusion restriction can be seen. Postcontrast MR images show strong and homogeneous enhancement. Cyst formation can be detected in 30% and peritumoral brain edema in nearly 100% of the cases.
Case courtesy of Dr. Amr Abdel Fatah, Lecturer of Radiodiagnosis, Kasr Al Ainy Hospital.