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AJNR - American Journal of Neuroradiology

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MR Features of Cerebral Aspergillosis in an Immunocompetent Patient: Correlation with Histology and Elemental Analysis

Warinthorn Phuttharak^a, John R. Hesselink^a and Christopher Wixom^b

^a Department of Radiology, University of California, San Diego, San Diego, CA
^b Department of Pathology, University of California, San Diego, San Diego, CA

View larger version (117K): [in a new window]   FIG 1. CT scan of the brain. Axial precontrast scan shows a large, isoattenuated left temporoparieto-occipital mass with central hypoattenuated areas of necrosis and one focal calcification.

View larger version (69K): [in a new window]   FIG 2. Brain MR imaging. A, Sagittal T1-weighted image shows the extent of the large mass, which is mostly isointense to gray matter with a mildly hyperintense perimeter. B, Axial T2-weighted image demonstrates the hypointense wall of the mass with surrounding brain edema. Thin, interrupted, low signal intensity zones (arrows) line the margin between the outer wall and central hyperintense necrotic area. C, Axial contrast-enhanced study reveals a thick, irregular enhancing rim. The low signal intensity zones (arrows) do not enhance.

View larger version (117K): [in a new window]   FIG 3. Histopathologic findings. A, Methanamin silver stain (magnification x200) shows dichotomous branching, septated fungi (arrows). B, Hematoxylin and eosin stain (magnification x200) reveals granulomas with epithelioid histiocytes and multinucleated giant cells (arrows). C, Perl stain (magnification x200) shows blue color staining of iron material (arrows).