title: Leukoencephalopathy with cerebral calcifications and cysts: clinical and pathological features in two adults.
abstract: Two adult patients diagnosed with Leukoencephalopathy with cerebral calcifications and cysts (LCC) were presented. Both patients had a long-term (8-10 years) following-up. Radiological findings of both patients revealed the characteristic signs of LCC: cerebral white matter abnormalities, calcifications, and cysts. In case 1, the initial CT scan showed a low-density area in the right frontal lobe and it had developed into a large cystic lesion after 8 years. Histopathological determination revealed that the cyst wall was associated with hemorrhage, angiomatous formation, and some Rosenthal fibers. In case 2, a major cystic lesion was located at the left parietal lobe which was resected and an old hematoma was found inside the cyst. Nine years later, the follow-up neuroimaging of case 2 showed a remarkable improvement of white matter abnormalities and cystic lesions. Hemorrhagic fluid was observed inside the cysts. Additionally, follow-up CT and MR scans showed a rapid enlargement of cystic lesions accompanied with hemorrhagic fluid levels after a year. Then, a major cyst was surgically removed to relieve pressure symptoms. Pathology of the resected cyst exhibited an organized hemorrhage inside the cyst and a large amount of hemosiderin surrounding the cyst wall. In conclusion, our two cases demonstrated that angiomatous changes subsequent with hemorrhage may be the major mechanism of cyst formation and development.
authors.affiliation: Department of Radiology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors.forename: Xueping
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Radiology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, China.
authors.forename: Qinglan
authors.initials: Q
authors.lastname: Sui
authors.affiliation: Department of Radiology, Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, China. cjr.xuwenjian@vip.163.com.
authors.forename: Wenjian
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Neuroradiology, Keck Medical Center, University of Southern California, Los Angeles, USA.
authors.forename: Chi-Shing
authors.initials: CS
authors.lastname: Zee
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000150:complications* / Q000473:pathology*; D020863:Central Nervous System Cysts / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000150:complications* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult
keywords: Cyst; Hemorrhage; Leukoencephalopathy; Magnetic resonance imaging; Tomography