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Temporal Giant Cell Reparative Granuloma: A Reappraisal of Pathology and Imaging Features

C. Reisa, J.M. Lopesb,d,e, E. Carneiroa, A. Vilarinhoc, R. Portugalb, F. Duartec and J. Fonsecaa

a Department of Neuroradiology, Hospital S. João, Porto, Portugal
b Department of Pathology, Hospital S. João, Porto, Portugal
c Department of Neurosurgery, Hospital S. João, Porto, Portugal
d Porto Medical School, Porto, Portugal
e IPATIMUP, Porto, Portugal


Figure 1
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  		Fig. 1. A, Axial non-enhanced CT scan (soft-tissue algorithm) shows a heterogeneous right temporal bone lesion, with cortical thinning and bone remodeling of the temporal squamous portion and lytic destruction of middle ear (B, axial CT scan, bone algorithm).


Figure 2
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  		Fig. 2. A, Coronal T2-weighted image shows a right temporal extra-axial lesion, mostly hyperintense but with surrounding and septal areas of low signal intensity. Note a mild mass effect on the temporal parenchyma. There is no evidence of condyle destruction of the mandible. B, Contrast-enhanced coronal T1-weighted image shows the lesion occupying the right middle ear, which enhances heterogeneously after gadolinium. There is enhancement in the adjacent temporal dura.


Figure 3
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  		Fig. 3. GCRG light microscopy discloses heterogeneous areas with multinucleated cells (A), alternating with spindle and xanthomatous cells (B). The lesion infiltrates the adjacent bone (C), both depicting similar heterogeneous features (D). Note signs of recent (B) and old hemorrhage (A, C, D).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X