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Fig. 1 | BMC Neurology

Fig. 1

From: Anomalous vascularization in a Wnt medulloblastoma: a case report

Fig. 1

MRI and histological findings in the hemorrhagic lesion. (A) [CT and MRI findings in the hemorrhagic cerebellar lesion]. Sagittal (a) and Axial (b) MDCT reconstruction images show a hyperdense cerebellar-vermian lesion, with fluid-blood levels (white arrows), confirmed by MRI scan. Axial T2-weighted MRI (c) showed a hemorrhagic cerebellar-vermian lesion, expanding into IV ventricle, with multiple fluid-blood levels (white arrow). Axial-Sagittal T1-weighted MRI, without (d, e) and with (f, g) gadolinium, revealed a solid component inhomogeneously contrast-enhanced (white arrows). Axial gradient-echo sequence (h) showed lack of hypointense hemosiderin rim (cavernous hemangioma classical finding, white arrow). Preoperative left vertebral angiograms (i, l) show hypoplastic vertebral artery terminating as posterior inferior cerebellar artery (vascular variation) and the tumor stain; an aneurysm-like formation (arrow) is seen in the arterial phase. The tumor is fed by the vermian branch of the left posterior inferior cerebellar artery. (B) [Histological findings in hemorrhagic medulloblastoma]. Proliferation of small undifferentiated cells showing a diffuse/multinodular pattern (middle-right), associated to anomalous, thick-walled vascular structures (arrows) (a, H&E, 2.5x). Cells were synaptophysin (b, 20x) and beta-catenin (both cytoplasm and nucleus) positive (c, 20x). Anomalous vascularization was characterized by clusters of anomalous, thick-walled arterial-type vessels (d and f, CD31 20x) along with numerous variably anastomosing small venous and capillary structures (e, CD31, 20x)

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