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Xanthoma Disseminatum of the Central Nervous System and Cranium

I.T. Zaka, D. Altinoka, S.S.F. Neilsenb and K.K. Kisha

a Department of Radiology, Wayne State University, Detroit, Mich
b Department of Radiology, Michigan State University, Lansing, Mich


Figure 1
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  		Fig 1. Case 1: A, Axial T1-weighted image shows a large heterogeneous mass lesion in the right thalamus with mild local mass effect.

B, Axial T2-weighted image shows a poorly defined heterogeneous mass with a small amount of vasogenic edema.

C, Axial T1-weighted image postgadolinium shows intense and heterogeneous enhancement of the mass lesion.


Figure 2
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  		Fig 2. Case 1. Sagittal T1-weighted image of the whole spine shows multiple intra- and extra-axial lesions with intense enhancement.


Figure 3
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  		Fig 3. Case 2. A, Sagittal T1-weighted image shows a large heterogeneous extra-axial mass in the posterior fossa with central hemorrhage.

B, Sagittal T1-weighted image shows intense enhancement of the tumor. Notice the relationship of the tumor to the dura and the lack of a dural tail sign.


Figure 4
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  		Fig 4. Case 3. A, Axial T2-weighted image shows minimal vasogenic edema in the outer aspect of the adjacent parietal lobe.

B, Coronal T1-weighted image postgadolinium shows intense enhancement and a dural tail sign.


Figure 5
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  		Fig 5. Photomicrographs of a specimen from case 1 (Courtesy of William Kupsky, MD, Wayne State University, Detroit, Mich).

A, Hematoxylin and eosin stain (x400) shows numerous irregular large cells with abundant foamy cytoplasm and vesicular nuclei.

B, Xanthoma disseminatum cells stain (x400) strongly positive for the CD68 marker.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X