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Facet Subluxation
Joseph Junewick, MD FACR
over 7 years ago
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LCH Choroid Plexus

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Child with Langerhans cell histiocytosis and new neurological symptoms.


Case Images


Diagnosis

LCH Choroid Plexus

Findings

MR – Markedly enlarged choroid in the atria and 4th ventricle with T2 hypointensity and psot-gadolinium T1 hyperintensity. Also note enhancing dural plaques.

Discussion

The choroid plexus forms as a result of invagination of pia mater through the neural tube into the ventricluar system, bringing along blood vessels and ependyma. The main role of the choroid is cerebrospinal fluid homeostasis. but it also plays an important role in extension of disease from the brain parenchyma and meninges.

The blood vessels of the choroid are fenestrated which allow free movement of many substances. Choroid plexitis may be related to tuberculosis, Cryptococcus, Cytomegalovirus, Nocardia, and Toxoplasmosis infections. Granulomatous diseases such as Langerhans cell histiocytosis can also be seen. Typically, the choroid plexus is enlarged with intense enhancement; occasionally there is ependymal enhancement and/or periventricular edema.

LCH is a disorder of immune dysfunction related to clonal proliferation of Langerhans cells. The typical patient is a young male caucasion although all ages, genders and races can be affected. Prognosis is related to the extent of systemic involvement. LCH can involve any organ.

Reference

Naeini RM, Yoo JH, Hunter JV. Spectrum of Choroid Plexus Lesions in Children. AJR (2009); 192:32-40.

Contributor

WL Schey, MD



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