Journal of Pediatric Neurosciences
NEUROIMAGING
Year
: 2020  |  Volume : 15  |  Issue : 3  |  Page : 330--331

Bilateral xanthogranuloma of the choroid plexus in an infant


Sachinkumar M Patel1, Sanjukta De2, Sayan Das3, Prasad Krishnan1,  
1 Department of Neurosurgery, National Neurosciences Centre, Kolkata, West Bengal, India
2 Department of Paediatrics, Peerless Hospital and B K Roy Research Centre, Kolkata, West Bengal, India
3 Department of Radiology, Peerless Hospital and B K Roy Research Centre, Kolkata, West Bengal, India

Correspondence Address:
Dr. Prasad Krishnan
Department of Neurosurgery, National Neurosciences Centre, Peerless Hospital Campus, 2nd Floor 360 Panchasayar, Kolkata, West Bengal.
India

Abstract

Xanthogranuloma of the choroid plexus is a rare, usually incidentally detected and commonly bilateral intraventricular lesion found in the pediatric population. Its characteristic imaging features are described.



How to cite this article:
Patel SM, De S, Das S, Krishnan P. Bilateral xanthogranuloma of the choroid plexus in an infant.J Pediatr Neurosci 2020;15:330-331


How to cite this URL:
Patel SM, De S, Das S, Krishnan P. Bilateral xanthogranuloma of the choroid plexus in an infant. J Pediatr Neurosci [serial online] 2020 [cited 2021 Jan 26 ];15:330-331
Available from: https://www.pediatricneurosciences.com/text.asp?2020/15/3/330/300047


Full Text



A 1-month-old child underwent a magnetic resonance imaging (MRI) study following recovery from neonatal meningitis and septicemia (as ultrasound examination of the brain to see for hydrocephalus had suggested some pathology in the lateral ventricles). T1-weighted imaging showed bilaterally symmetric hyperintense mass in abutting walls of both lateral ventricles. The lesion was isointense on T2 sequences and showed restriction on diffusion-weighted imaging (DWI). It appeared to be attached to the choroid plexus and had areas of hemorrhage seen on gradient recalled echo (GRE) sequences [Figure 1] and [Figure 2]. A provisional diagnosis of xanthogranuloma of the choroid plexus was made.{Figure 1} {Figure 2}

Xanthogranulomas of the choroid plexus are benign and rare lesions occurring in the choroid plexus of the lateral and third ventricles.[1],[2] Though on occasion, they may cause hydrocephalus or intraventricular hemorrhage, they are usually asymptomatic and found incidentally while imaging for other conditions.[1],[2] They are usually bilateral[3] and have an autopsy incidence of 1.6%–7.0%[1],[2] with many of these being extremely small and insignificant. They are different from choroid plexus cysts which are commonly seen on antenatal ultrasound (1% of all cases) and are formed by infolding of the neuroepithelium into the stroma and usually disappear by the 28th week of gestation.[4]

Yetkinel and Bek[2] have described their micro-architecture as consisting of “cholesterol clefts, lymphocyctic infiltration, giant cells with multiple nucleoli, foamy macrophages (xanthoma cells), fibrous proliferation, and hemosiderin deposits.” Several causes of pathogenesis ranging from cellular degeneration (desquamation of cuboidal epithelial cells and their sequestration), tissue reaction to hemorrhage, and even systemic disturbances of lipid metabolism have been put forth.[1],[2] Hemorrhages at the periphery of these lesions or pathological accumulation of lipids leading to inflammation may manifest as hyperintensities adjacent to the lesions on T2-weighted sequences. In our patient, hyperintensities in the white matter might also have been consequent to the hemorrhage in the cysts or a sequelae of meningitis. However, diffusion restriction in DWI sequences and the fact that the lesions were bilateral (a pathognomonic radiological finding[2]) led us to this diagnosis.

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Conflicts of interest

There are no conflicts of interest.

References

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4Naeini RM, Yoo JH, Hunter JV Spectrum of choroid plexus lesions in children. AJR Am J Roentgenol 2009;192: 32-40.