giovedì 8 marzo 2007

Gray matter heterotopia and Lipoma


The lateral ventricles and 3rd ventricle are slightly increased in size. There is heterotopia along the lateral posterior aspect of the body of the L lateral ventricle. There is a posterior midline fatty lesion consistent with lipoma.

Differential diagnosis for the posterior midline findings:
- Lipoma
- Dermoid or teratoma (Should have more heterogeneity and not be as low in overall density)
- Lipomatous differentiation or transformation of neoplasm or cerebellar lipo- neurocytoma (again, more heterogeneous)

Differential diagnosis for the left lateral ventricle finding:
- Gray matter heterotopia
- Tuberous sclerosis subependymal nodules (frequently calcify and enhance)

Diagnosis: Gray matter heterotopia and Lipoma

Key points

Gray matter heterotopias:
- Are migrational disorders.
- Can result in seizures.
- Associated with many syndromes, most commonly Chiari II and agenesis of the corpus callosum.

CNS lipomas:
- Are congenital malformations and not true neoplasms.
- Are due to maldevelopment of the meninx primitive.
- Often associated with agenesis of the corpus callosum.
- About half are seen in the interhemispheric fissure.
- Many calcify, but rarely in the posterior fossa.

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