Idiopathic Hypereosinophilic Syndrome with Skull Base Involvement
M.L. Battinenia,
S.L. Galettac,
J. Oha,
M. Langof,
J.J. Brookse,
S.J. Schusterb and
L.A. Loevnera,d
a Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa
b Department of Hematology/Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pa
c Department of Neurology and Opthalmology, Hospital of the University of Pennsylvania, Philadelphia, Pa
d Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
e Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pa
f Department of Head and Neck Surgery, Fox Chase Cancer Center, Philadelphia, Pa
View larger version (57K):
[in this window]
[in a new window]
|
Fig 1. A 46-year-old woman with a history of idiopathic hypereosinophilic syndrome presented with multiple cranial nerve palsies.
A, Axial T2-weighted MR image shows a hypointense left skull base mass (arrows) at the region of the left basisphenoid.
B, Enhanced fat-suppressed axial T1-weighted MR image demonstrates the enhancing left skull base mass with involvement of the clivus (C), foramen rotundum (thin arrows), dura (thick arrows), and pterygopalatine fossa (P).
C, Enhanced fat-suppressed axial T1-weighted MR image shows a solidly enhancing mass (similar in appearance to a meningioma) involving the left cavernous sinus with some narrowing of the adjacent internal carotid artery (thin arrow), with associated thick dural enhancement (thick arrows). Also note involvement of the left orbital apex (O).
| |
View larger version (76K):
[in this window]
[in a new window]
|
Fig 2. A, At medium power, most tissue fragments showed attenuated fibrosis (thick arrows) around nerves (thin arrows) and vessels (arrowhead), along with crushed inflammatory cells. Focal areas of fat necrosis are present at the periphery of the fibroinflammatory mass. (hematoxylin-eosin [H&E], original magnification x100)
B. At high power, lymphocytes, histiocytes, plasma cells (arrow), and scattered eosinophils (arrowhead) are seen within the fatty tissue. (H&E, original magnification x400)
| |
