Brain Pathology Case of the Month - January 1997


All sections showed a perivascular proliferation of spindle-shaped cells ensheathing numerous blood vessels present in the leptomeninges and the entire cortex (Image 1, Images 2, Image 3), but not in the white matter, which exhibited cystic changes (Image 4, Image 5). Many of these vessels were thickened in a concentric fashion. Gomori trichrome (Image 6) revealed dense collagen deposition accompanying the fibroblastic proliferation . Meningothelial cells were scanty and EMA immunohistochemistry showed only occasional positive cells within the cortical lesion. The intervening parenchyma contained many pyramidal neurons (Image 7), most of which were morphologically normal, however, there was considerable gliosis (Image 8). An occasional neuron contained a neurofibrillary tangle (Image 9), but none showed granulovacuolar degeneration. Psammoma bodies (Image 10) were present in some areas, especially in the superficial cortex.


International Society of Neuropathology