Infarction of the choroid plexus

Infarction of the choroid plexus may result from ischemia in the distribution of the medial posterior choroidal artery. Diffusion-weighted imaging may depict this unusual stroke syndrome. The clinical and radiologic aspects of this rare condition are discussed taking into consideration the anatomy and pathophysiology of the choroid plexus.     

Xanthogranulomas of choroid plexus

Summary Computed tomographic features of xanthogranulomas of the choroid plexus are presented. The characteristic location of bilateral intense homogeneously enhanced masses with central lucencies is thought to be diagnostic of xanthogranuloma of the choroid plexus.     

Inflammatory pseudotumor of the choroid plexus.

A case of inflammatory pseudotumor is described, in which CT revealed a hyperdense intraventricular lesion with a trapped temporal horn, and MR imaging showed decreased T1 and markedly hypointense T2 signal with homogeneously intense enhancement. Radiologically and grossly the tumor resembled a meningioma; however, histologically it was composed purely of inflammatory, nonneoplastic components. The lesion was resected with no evidence of recurrence at 5-month follow-up.     

Papilloma and carcinoma of the choroid plexus in pediatric patients

Papillomas of the choroid plexus are rare tumors of neuroectodermal origin; they represent less than 5% of all central nervous system (CNS) tumors in pediatric patients. Choroid plexus carcinomas are even rarer. We reviewed the incidence of these neoplasms at our reference hospital and found six tumors of the choroid plexus (five papillomas and one carcinoma) in five patients. Patient age ranged from prenatal to 25 months. All five patients underwent computed tomography (CT) examination. Four perinatal patients underwent ultrasound examination, four magnetic resonance imaging (MRI), and one (years ago) angiography. All patients had tumors located in the lateral ventricles, and one patient had a second tumor located in the third ventricle. These tumors are predominantly solid, intraventricular, with well-defined polylobulated margins. They show intense vascularization on Doppler studies and marked contrast enhancement on CT and MRI studies. Hydrocephalus was present in three cases. All patients underwent surgery; total resection was achieved in the five papillomas, whereas the carcinoma was partially resected and the patient is currently undergoing chemotherapy. The three patients with a single papilloma are disease free at follow-up (range 7 months to 11 years). The patient with two papillomas shows good recovery at follow-up, whereas the patient with carcinoma of the choroid plexus has a poor prognosis.     

Diagnostic imaging of choroid plexus disease

Disorders of the choroid plexus, a central nervous system structure, are rare, but can pose diagnostic difficulties. The purpose of this review is to illustrate the computed tomography and magnetic resonance imaging findings of a wide spectrum of lesions that affect the choroid plexus. The areas covered include (1) neoplasms (papilloma, leukaemia, meningioma, lymphoma and metastases); (2) infections (bacterial, fungal and viral); (3) cysts; (4) haemorrhage; (5) congenital abnormalities (Sturge-Weber syndrome, Klippel-Trenaunay-Weber syndrome and vascular malformations); and (6) non-infectious inflammatory disorders (xanthogranulomas, inflammatory pseudotumour, neurosarcoidosis, rheumatoid nodule and villous hypertrophy). Few of the patterns of choroid plexus involvement are specific for a particular pathological process. Guermazi, A. (2000) Clinical Radiology 55, 503-516.     

MRI findings of choroid plexus tumors in the cerebellum

Choroid plexus tumors (CPTs) are uncommon primary intracranial tumors. Here, we describe two patients with CPTs of the cerebellum: one had a choroid plexus papilloma located in the left cerebellar hemisphere that presented as an irregular, lobulated and solid-cystic mass, whereas the other had a choroid plexus carcinoma that exhibited a poorly defined, mixed-intensity mass associated with invasion of adjacent brain parenchyma. Contrast-enhanced MR imaging showed prominent heterogeneous enhancement. CPTs should be considered in the differential diagnosis for irregular, heterogeneous and intensely enhancing masses that occur in the cerebellum.     

Computed tomography of choroid plexus lesions

Computed tomographic (CT) and clinical findings in 14 patients with 17 lesions of the choroid plexus are presented. Primary neoplasms are the most common lesions in this series and include papiliomas, meningiomas, carcinoma, astrocytoma, and teratocarcinoma. There are five vascular lesions, consisting of cavernous angiomas, hemangiomas, and an arteriovenous malformation. One patient had bilateral xanthogranulomus. There was association between cavernous angiomas and Sturge-Weber, and between meningiomas and neurofibro natosis. Useful distingiushing clinical and CT features between the different types of lesions are discussed.     

MRI of hemorrhagic choroid plexus cyst

An unusual case of hemorrhage within a cyst in the choroid plexus of the lateral ventricle is presented. choroid plexus cysts are commonly found incidentally on imaging studies, particularly MRI, where their characteristic appearance produces little diagnostic difficulty. In this case, high signal intensity of the cyst contents on T1-weighted images and apparent hemosiderin deposition in the cyst wall, not previously described, represented a dramatic change from a study 10 weeks previously and allowed a presumptive diagnosis of hemorrhage into the cyst, a presumption further supported by the changes in signal 20 weeks later.