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Figures
- FIG 1.
Tumor appearance on MR imaging. MR images show a right posterior fossa mass, which had isointense signal on pregadolinium T1WI (A) and hypointense signal on T2WI (B) and FLAIR (C) with perilesional edema (B and C). The mass does not show diffusion restriction on DWI (D). There are a few blooming foci within the tumor seen on SWI (E). The mass shows intense enhancement with multifocal, small, nonenhancing areas of necrosis on axial postgadolinium T1WI (F). Sagittal postgadolinium T1WI (G) demonstrates the tumor attached to the inferior surface of the right tentorium cerebelli (arrow). On DSC MR perfusion (H), the tumor had low rCBV.
- FIG 2.
Histopathology. H&E-stained sections A, B, and C (magnification A, bar 4 mm; B, bar 200 um; and C, bar 300 um). A, The attachment to the dura mater is demonstrated at the lower right (arrow). B, Cells have spindle-shaped nuclei with blunted ends and wavy eosinophilic cytoplasm of uncertain limits and are arranged in intersecting streams and whorls. The tendency to surround blood vessels is seen in A and C (arrowheads). Reticulin stains demonstrate wrapping of single cells, with no reticulin-free areas (D, bar 200 um). Immunohistochemistry shows expression of smooth-muscle actin (E, bar 200 um) and myosin (F, bar 200 um) with only a subset of cells expressing desmin (G, bar 200 um). The Ki-67 proliferation index was approximately 2%; high only in the lining of blood vessels (H, bar 200 um). EBV-encoded RNA in situ hybridization was intensely positive (I, bar 200 um).
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