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Figures
- Fig 2.
Typical radiologic features of intra-axial CAPNON. A, Noncontrast CT scan shows a left hippocampal mass with attenuated calcification. B, Coronal T2-weighted sequence demonstrates T2 hypointensity with a nodular border. C, Coronal T1-weighted sequence shows the typical T1 hypointensity. Preoperatively, this lesion was thought to represent a cavernous malformation. In retrospect, the nodular contour on T2 and lack of internal T2 hyperintensity would be atypical for a cavernous malformation of this size.
- Fig 3.
Typical histopathologic features of CAPNON. A, The typical chondromyxoid matrix of CAPNON (H&E, original magnification ×100). B, Focal osseous metaplasia is seen in all 4 cases (H&E, original magnification ×100). C, Medium-power magnification of the chondromyxoid matrix and the peripheral spindle cells (H&E, original magnification ×200). D, Immunohistochemical analysis for EMA demonstrating positive staining in the spindle cells surrounding the matrix (EMA immunohistochemistry, original magnification ×200).
- Fig 4.
Atypical and unusual features of CAPNON. A, Areas of coalescent concentric lamellar calcifications without intervening chondromyxoid matrix or cells (H&E, original magnification ×100). B, More basophilic amorphous lamellar calcifications without intervening chondromyxoid matrix and with rare meningothelial cells (H&E, original magnification ×100). C, Adjacent cortical region showing meningioangiomatosis (H&E, original magnification ×200). D, Surrounding parenchyma with prominent perivascular lymphocytic infiltrates and Rosenthal fibers (H&E, original magnification ×200).
Tables
References Pt No. Age/Sex Location CT Performed Presentation Rhodes & Davis, 1978 1 27/F R frontal No HA 2 55/F Brain, dura No Autopsy finding 3 60/M L cerebellum No Autopsy finding 4 74/F Brain, dura No Autopsy finding 5 46/M Choroid No Autopsy finding 6 62/M Pineal No Autopsy finding 7 83/M Brain, dura No Autopsy finding Jun, 1984 8 55/M Corpus callosum Calc HA, N/V Garen, 1989 9 44/M Dura, Meckel cave Calc Atypical facial pain Bertoni, 1990 10 31/M Jugular foramen No HA, hoarseness 11 50/M Foramen magnum No Neck pain 12 48/M Skull base/cerebellum No R CN XI paralysis 13 23/M Spine, T10 No Back pain 14 58/M Spine, C2–3 No Back pain 15 32/M L frontal No Epilepsy 16 45/F Skull base No CN paralysis 17 58/M Skull base No Hoarseness 18 12/M Spine, C6 No Pain 19 32/M Spine, L4–5 No Back pain 20 33/F Spine, T9 No Back pain 21 68/F Spine, L4–5 No R hip pain 22 20/F Spine, C2 No Incidental 23 56/F Spine, L4–5 No Back pain Smith, 1994 24 48/M Spine, L2–3 No Sciatica Tsugu, 1999 25 22/F R parietal Calc Seizures Tatke, 2001 26 6/M L temporal Calc Seizures Qian, 1999 27 33/F L temporal Calc Developmental delay 28 49/M Spine, C1 & clivus No Weakness 29 59/M Spine, C1–2 No Shuffling gait 30 47/F Frontal lobe Calc Seizures Note:—CAPNON indicates calcifying pseudoneoplasms of the neuraxis; calc, densely calcified mass seen on CT; CN, cranial nerve; HA, headache; N/V, nausea and vomiting; L, left; R, right.
* This table includes an additional 30 patients from the literature with intracranial and intraspinal CAPNON.
Pt No. Age/Sex Presentation Location Size (cm) T1WI T2WI Enhancement 1 16/M Incidental Temporal horn, extra-axial 3.5 Hypo Hypo Internal linear C+ 2 35/M Seizures Temporal, intra-axial 2 Hypo Hypo Internal linear C+ 3 49/F Seizures Hippocampus, intra-axial 1 Hypo Hypo No C+ 4 59/M Left arm numbness Parietal, intra-axial 1 Hypo Hypo Rim C+ Shrier et al 32/F Incidental Temporal, intra-axial 0.8 Hypo Hypo Rim C+ Shrier et al 59/M Neck pain Foramen magnum, extra-axial 2 Hypo Hypo Heterogenous solid Note:—Hypo, indicates hypointense; C+, enhancement. All lesions showed dense calcification on CT; T1WI, T1-weighted imaging; T2WI, T2-weighted imaging.
* This table includes our 4 patients and 2 additional patients reported in the literature.
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