Figure MRI and leptomeningeal biopsy findings in Vogt-Koyanagi-Harada syndrome involving the cerebellopontine angle(A) Coronal and (B) axial gadolinium-enhanced.

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Presentation transcript:

Figure MRI and leptomeningeal biopsy findings in Vogt-Koyanagi-Harada syndrome involving the cerebellopontine angle(A) Coronal and (B) axial gadolinium-enhanced T1-weighted sequences before initiation of corticosteroid therapy showing diffuse nodular pachymeningeal thickening and enhancement (red arrowheads). MRI and leptomeningeal biopsy findings in Vogt-Koyanagi-Harada syndrome involving the cerebellopontine angle(A) Coronal and (B) axial gadolinium-enhanced T1-weighted sequences before initiation of corticosteroid therapy showing diffuse nodular pachymeningeal thickening and enhancement (red arrowheads). Also seen is a heterogeneously enhancing soft tissue mass in the right cerebellopontine angle (white arrows) extending into the internal auditory canal. Of note, there is mild truncation (or Gibbs) artifact in (A). (C–F) Pathology of leptomeningeal biopsy. (C) Gross view of surgical field, revealing diffuse brown discoloration of dura mater. (D) CD3-positive (40×) T lymphocytes are present. (E) Numerous CD68-positive (40×) macrophages (black arrows) containing melanin granules. (F) Fontana-Masson stain (100× oil immersion) demonstrates melanin granules within macrophages (light blue arrows). Faheem Sheriff et al. Neurol Neuroimmunol Neuroinflamm 2014;1:e49 © 2014 American Academy of Neurology