Spectroscopic increase in choline signal is a nonspecific marker for differentiation of infective/inflammatory from neoplastic lesions of the brain.
We report in vivo proton magnetic resonance (MR) spectroscopic findings in three benign infective/inflammatory lesions (one case each of tuberculoma, fungal granuloma, and xanthogranuloma), which showed high choline along with the presence of lipid/lactate, a feature characteristically described in neoplastic lesions. Histopathology of the lesions showed inflammatory cellular infiltrates with areas of necrosis/caseation. The spectroscopic-visible increased choline resonance in these lesions is probably the result of cellularity. We conclude that increased choline, along with the presence of lipid/lactate is a nonspecific finding and may not be of much value in the differentiation of neoplastic from nonneoplastic infective/inflammatory intracranial mass lesions.
Venkatesh
S K
SK
Departments of Radiology and Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Gupta
R K
RK
Pal
L
L
Husain
N
N
Husain
M
M
D000293:Adolescent; D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis / Q000473:pathology; D001231:Aspergillus flavus; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis* / Q000473:pathology; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008581:Meningitis / Q000175:diagnosis* / Q000473:pathology; D016921:Meningitis, Fungal / Q000175:diagnosis / Q000473:pathology; D014375:Tuberculoma / Q000175:diagnosis / Q000473:pathology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000473:pathology; D014972:Xanthogranuloma, Juvenile / Q000175:diagnosis / Q000473:pathology