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May 2004: newborn with intracranial mass
Stefanie Scheil1, Torsten Horn, Ulrich Kunz
1Institute of Pathology, Laboratory of Neuropathology, University Hospitals of Ulm, Germany.
Abstract:
May 2004: We present the case of a male newborn (38th week of gestation) with a 3-week history of a sonographically detected parietal mass of 5-cm diameter. The entire mass was removed at surgery. Surprisingly, microscopy revealed an intracerebral hemorrhage and nests of glycophorin-A immunoreactive blasts and nucleated erythrocytes in the surrounding parenchyma. The final diagnosis was chronic intracerebral hemorrhage of unknown etiology with reactive changes of the surrounding brain tissue and perifocal extramedullary erythropoiesis. This case is unique because, to date, intracranial extramedullary erythropoiesis has only been described in chronic subdural hemorrhage.
Insights
This study reports a rare case of a newborn with chronic intracerebral hemorrhage and extramedullary erythropoiesis. The findings suggest this condition can occur within the brain parenchyma, not just subdural spaces.
Area of Science:
- Neuropathology
- Neonatal Medicine
- Hematology
Background:
- Extramedullary erythropoiesis, the formation of red blood cells outside the bone marrow, is typically associated with hematological disorders or extramedullary sites like the spleen or liver.
- Intracranial extramedullary erythropoiesis has been previously documented exclusively in the context of chronic subdural hematomas.
Observation:
- A male newborn presented with a sonographically detected 5-cm parietal mass.
- Surgical removal of the mass revealed an intracerebral hemorrhage.
- Microscopic examination identified glycophorin-A immunoreactive blasts and nucleated erythrocytes within the surrounding brain parenchyma.
Findings:
- The final diagnosis was chronic intracerebral hemorrhage of unknown etiology.
- The hemorrhage was associated with reactive changes in the brain tissue.
- Perifocal extramedullary erythropoiesis was observed in the brain parenchyma surrounding the hemorrhage.
Implications:
- This case expands the known locations for intracranial extramedullary erythropoiesis.
- It suggests a potential link between intracerebral hemorrhage and extramedullary erythropoiesis in neonates.
- Further research is warranted to understand the etiology and mechanisms of this rare phenomenon.
