Unusual Appearance of a Cisternal Hydatid Cyst
Zoran Rumboldta,
Hrvoje Jedna
akb,
Jasna Talan-Hranilovi
c,
Tihana Rumboldta and
Miljenko Kalouseka
a Department of Radiology, University Hospital "Sisters of Mercy," Zagreb, Croatia
b Department of Neurosurgery, University Hospital "Sisters of Mercy," Zagreb, Croatia
c Department of Pathology, University Hospital "Sisters of Mercy," Zagreb, Croatia
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FIG 1. Images from the case of a 50-year-old man with cerebral hydatid disease.
A–C, Sagittal spin-echo T1-weighted MR images (584/12 [TR/TE]) show a multilocular mass in the premedullary cistern, extending from the lower pons to the C1 level. The central part of the lesion is isointense with the brain stem, whereas the superior portion is of lower signal intensity (open arrows). The inferior aspect of the mass is hyperintense, with an appearance of nondependent levels, best seen in C (arrowheads). The layering appearance is best appreciated in A.
D and E, Coronal spin-echo T2-weighted MR images (1858/80) show the lesion in the subarachnoid space, located in the midline and extending to the right (open arrows). The lesion is predominantly hyperintense compared with CSF, with low signal intensity in its inferiormost portion, which is well delineated (arrowheads). A subtle transitional zone can be seen just above this hypointense area.
F, Photomicrograph of the hydatid cyst wall shows the germinative epithelium, with ruptured daughter vesicles. A number of scolices are seen, predominantly in the vicinity of the daughter vesicles. The laminated membrane is found on the outer aspect of the germinative epithelium (Mallory; original magnification, x400).
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