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Case No. 413
2016-07-01~2016-07-31
출제자 : 안성수
Hit : 365
| Period | 2016-07-01~2016-07-31 |
|---|---|
| Diagnosis | Cholesterol granuloma |
| Clinical information | F/55 CC: Headache |
| Discussion | <문제해설> There is a well-defined mass-like lesion showing central hyperintensity with peripheral low signal rim on T1WI and T2WI, arising from the left petrous bone. Contrast-enhanced T1WI shows no enhancement. High attenuation is seen at the periphery of the lesion on CT. Adjacent petrous bone erosion is associated. Cholesterol granuloma is a special type of middle ear granulation tissue which is prone to bleeding. It often affects patients with a history of chronic otitis media. The mastoid air cells are the most commonly involved location, and petrous bone and middle ear can be affected. Histologically, cholesterol granulomas contain cholesterol crystals, which accounts for the high T1 and T2 signal intensity, and hemosiderin from recurrent hemorrhage, which accounts for peripheral low signal rim. It can be associated with bony erosions and sometimes it can extend to the carotid canal or cerebellopontine angle. In symptomatic cases, surgical excision is the treatment of choice. |
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