Brain Pathology Case of the Month - June 2009

Contributed by Susanne K. Jeffus, M.D., T. David Bourne, M.D., M. Beatriz S. Lopes, M.D., Ph.D.
University of Virginia Health System, Department of Pathology, Charlottesville, VA


The patient was a 58-year-old African American woman with severe static encephalopathy and cerebral palsy both presumptively related to prenatal/perinatal brain injury. Additional neurological diagnoses included an ill-defined seizure history, bipolar affective disorder, and medication-related tardive dyskinesia. The patient's other co-morbidities were non-contributory. She was a permanent resident of a long-term care facility, where she expired unexpectedly. An autopsy was requested.


The 1120 gram brain was grossly normal on external examination. However, coronal sections demonstrated an ill-defined nodule within the right side of the corpus callosum composed of heterogeneous areas of firm, white tissue and soft, yellow areas (Figure 1).

Microscopically, the nodule consisted of mature adipose tissue, collagen, and blood vessels surrounded by callosal fibers (Figure 2). Trichrome stain confirmed the presence of collagen (Figure 2B). Immunohistochemical stains including SMA, HMB-45, and myogenin were negative. The remaining analysis of the brain was remarkable only for hypertensive vascular changes. Of note, there was no evidence of other malformative lesions and no signs of chronic hypoxic-ischemic damage.


International Society of Neuropathology