What are the typical demographics of individuals with choroid plexus xanthogranulomas?
Adult choroid cysts and xanthogranulomas should not be confused with antenatal choroid cysts, which usually regress by birth. These lesions are found in adults, and are relatively common (~7%), identified most commonly in older patients
What is the histology of these lesions?
These lesions represent desquamated epithelium into the lumen of choroid cysts within the choroid plexus. As a result cholesterol / lipid rich content of epithelial cells accumulates, sometimes combined with blood products, and results in a xanthomatous response, as this material is ingested by mononuclear cells. Histologically these lesions are characterised by xanthomatous debris filling needlelike spaces representing the apparent site of lipid crystals admixed with blood pigments, multinucleate histiocytes, and focal collections of foamy histiocytes.
What treatment is required?
These lesions require no treatment. They do not require histological confirmation and no follow up is needed.
Single image through the lateral ventricles, demonstrates near-CSF attenuation cystic structures in the trigones consistent with choroid plexus granulomas. Flecks of calcium are scattered around their periphery.