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An enhancing multicystic mass in the superior frontal gyrus of the right frontal lobe is demonstrated with surrounding vasogenic edema. It appears to be centered on the white matter.
The patient went on to have a craniotomy and biopsy.
Sections show multiple small fragments of neuropil containing focal collections of atypical ganglion cell neurons. These cells have large round nuclei with prominent nucleoli, abundant cytoplasm and peripheral Nissl substance. The cells are atypical in their morphology, orientation and spacial arrangement. Many blood vessels are surrounded by small cuffs of reactive lymphocytes. The intervening neuropil shows a mild degree of reactive gliosis, occasional axonal steroids and multiple small calcified deposits, resembling psammoma bodies. There does not appear to be any neoplastic glial component to this lesion.
Final Diagnosis: gangliocytoma.