Xanthogranulomatous colloid cyst of the third ventricle

Abstract

Colloid cyst in the third ventricle is a common entity, whereas a variant of it, namely xanthogranulomatous, is quite rare. The closest imaging differential diagnosis is a purely third ventricular craniopharyngioma. We herein describe a case of xanthogranulomatous colloid cyst presenting with hydrocephalus.

Keywords: Colloid cyst; third ventricle; xanthogranuloma.

Figure 1

MRI T1W sagittal (a), T2W coronal (b), T1 contrast sagittal (c) images showing a solid cystic third ventricular lesion hyper on T1W and T2W images with hypointense solid portion and no enhancement on contrast (d) Post-operative CT scan demonstrating the complete excision of the lesion with the catheter tip in the third ventricle

Figure 2

Histopathological sections (a) cyst wall lined by a single layer of cuboidal cells with underlying eosinophilic, homogenous colloid, and xanthogranulomatous reaction (hematoxylin and eosin stain [H and E], ×100); (b) colloid contents cross-hatched by cholesterol clefts (H and E, ×400); (c) magnified view of granulomatous reaction showing giant cells, scattered lymphocytes admixed with neuropil material (H and E, ×200); and (d) high power view showing multinucleated giant cells (H and E, ×400)