Cell density of the corneal endothelium in human fetus by flat preparation

PURPOSE

To count the number of the corneal endothelial cells per unit of tissue area in 25 human fetal eyes ranging from 12-40 weeks of gestation with the histologic method.

METHODS

The endothelium including Descemet's membrane was stained with hematoxylin-eosin by the flat preparation method. We photographed the endothelium using light microscopy. The number of nuclei was counted on each photograph. A calibrated micrometer was photographed with the light microscopy, and this was used to measure the number of corneal endothelial cells per square millimeter.

RESULTS

The prenatal endothelial cell density of the human cornea decreases rapidly from 14,095 cells/mm2 (12 weeks of gestation) to 6,820 cells/mm2 (40 weeks of gestation).

CONCLUSION

The estimate of the endothelial cell density at 12 weeks of gestation is twofold higher than the estimate at 40 weeks of gestation.

MR imaging features of clear-cell meningioma with diffuse leptomeningeal seeding

Clear-cell meningioma is a rare disease entity showing a more aggressive nature, clinically, than those of other subtypes of meningioma. It occurs in younger persons and commonly in the spinal canal. The recurrence rate has been reported to be as high as 60%. We present a case of clear-cell meningioma in a 17-year-old man in whom initial MR imaging showed localized leptomeningeal enhancement that had progressed into the entire subarachnoid space after surgical resection of the primary tumor.

Ultrastructural changes in microvessel with age in the hippocampus of senescence-accelerated mouse (SAM)-P/10

Microvessels in the hippocampus of aged SAM-P/10 (14 months old) showed the following ultrastructural changes compared with those of young-mature controls (3 months old): (1) the majority of capillaries had lost the smooth contours typical of young cases; (2) the luminal surface of capillaries showed irregularity; (3) the endothelial cytoplasm was thicker; (4) vesicles appeared more frequently in the endothelium; (5) interendothelial tight junctions and basement membranes, however, seemed to show no significant abnormalities; (6) pericytes, especially those of arterioles and venules, contained many enlarged cytoplasmic inclusions with honeycomb-like vacuoles; (7) the area of glial perivascular end feet was greater. These morphological findings raise the possibility of impaired blood-brain barrier function and microhemodynamic disturbances in aged SAM-P/10 hippocampus.

Nitrofen-induced congenital malformations of the heart and great vessels in rats: an animal model

BACKGROUND

Nitrofen (2,4-dichloro-4'-nitrodiphenyl ether), a diapheny ether herbicide, is known to induce in rat fetuses a variety of congenital cardiovascular anomalies, together with diaphragmatic hernia and hydronephrosis. The purpose of the current study was to produce congenital cardiovascular anomalies in rat fetuses by oral nitrofen administration at the indicated doses and days of gestation, and to determine the characteristics of resulting nitrofen-induced cardiovascular anomalies.

METHODS

All the observed fetuses were removed from pregnant Sprague-Dawley rats killed on the 21st day of gestation. They were preserved in 10% formalin, and dissection for examination was carried out under a dissecting microscope.

RESULTS

The following results were based on dissecting microscopic findings of 482 offspring: (1) The 11th day of gestation was the most sensitive for nitrofen induction of congenital cardiovascular anomalies. The incidence of these was dose related. (2) Ventricular septal defect was the most common single cardiovascular anomaly, representing more than half of all such irregularities. The next most common were aortic arch anomalies and tetralogy of Fallot. (3) Cardiac anomalies derived from infundibular maldevelopment such as tetralogy of Fallot and pulmonary atresia with ventricular septal defect were observed only in the group treated with nitrofen on the 11th gestational day. (4) Aortic arch anomalies were very frequent; the great majority were anomalous right subclavian artery with left aortic arch.

CONCLUSION

This animal model is suitable for further embryological investigation of the development of congenital cardiovascular anomalies.

The histological spectrum of subperiosteal fibrocartilaginous pseudotumor of long bone (focal fibrocartilaginous dysplasia)

Clinicopathological features in six cases of focal fibrocartilaginous dysplasia (FFCD) which involved either the tibia (n = 4) or the femur (n = 2) were reviewed. All cases presented clinical and radiological characteristic features, and histopathological findings were analyzed in five of the six cases. The subject group comprised three boys and three girls, ages ranged from 12 to 18 months. Histologically, the individual lesions showed regional variation in cellularity, amount of fibrous and cartilaginous components. Paucicellular areas were mainly composed of dense fibrous tissue while more cellular areas contained foci of fibrocartilaginous element. The chondrocytes and stellate cells around cartilaginous area were positive for S-100 protein. One case contained both hyaline and fibrocartilage, and architecturally mimicked normal tendinous insertion. One case, which involved proximal tibia, was purely composed of fibrous tissue without fibrocartilage. All cases formed undulating and irregular borders against underlying cortical bone. Histopathologically variable spectrum suggests a strong possibility of undergoing transition from initial cellular and cartilagnous to late paucicellular, fibrous phase. Although any evidence that can explain basic pathogenesis or prognostic histological parameter is lacking, we believe that the term FFCD is not relevant because the presence of fibrocartilage is not an essential feature, and it can cause confusion with other pathological processes. We propose the term 'subperiosteal fibrocartilaginous pseudotumor of long bone' for this unique clinicopathological entity with which heterologous cartilaginous element can be associated.

Introduction and development of pathology

If one defines pathology as gross and microscopic examination of abnormal tissue there was no comparable discipline in traditional medicine of Korea until the introduction of Western medicine in Korea. However, when one widens the scope of pathology to include pathogenesis and etiology, there were some pathology-related descriptions in Oriental medicine long before this period. The pathology based on Virchow's cellular pathology was introduced to Korea through two tracks independently in 1910s. One was academic pathology, through Japanese pathologists, namely Dr. Inamoto and Dr. Tokumitzu, and the other track was hospital pathology through Western missionaries who introduced the American system of laboratory medicine (clinical pathology). It was Japanese who dominated the introduction and development in Korea. The Koreans played a minor role in the development of pathology from the introduction period until 1945, when the Korea was liberated from Japan. Pathology teaching, research and hospital service had been consistently carried out through three medical schools, namely Severance Medical School and two government medical schools until 1945. After independence, the Korean Society of Pathologists was quickly organized and made a rapid promotion. The Korean war provided opportunities to experience and adopt the American pathology system in Korea. The hospital pathology system has been established, together with the pathology specialty system in Korea. Balanced promotion of research pathology and service pathology is expected in Korea.

Insulin-like growth factor-II expression is down-regulated in TrkA-transfected SK-N-AS neuroblastoma cells

Expression level of trkA tyrosine kinase receptor for nerve growth factor is a major prognostic determinant of neuroblastoma, suggesting that defective trkA-mediated signaling is responsible for the tumorigenesis of this childhood malignancy. We investigated the biologic effect of trkA, with special reference to its effect on insulin-like growth factor-II (IGF-II) expression, in SK-N-AS human neuroblastoma cells transfected with human trkA cDNA. Nerve growth factor treatment of trkA-transfected cells promoted growth and changed the morphologic phenotype into a substrate-adherent, flatter phenotype (S-type), and down-regulated the mRNA expression of IGF-II. The effects on both growth and the morphologic differentiation of SK-N-AS cells differed significantly from those of previous studies, and implied that trkA effects can be diverse, depending on the phenotype of the individual neuroblastoma cells. Immunohistochemical screening of trkA and IGF-II expression in adrenal neuroblastomas (n = 25) also favored the nonoverlapping pattern of trkA and IGF-II expression (p < 0.05). Because IGF-II is believed to play a significant role in the tumorigenesis of neuroblastoma, the inverse relationship between trkA and IGF-II strongly suggests that a low level of trkA can be a feature of the pathogenetic mechanism of IGF-II expressing adrenal neuroblastomas.

Supratentorial primitive neuroectodermal tumor in children: clinical features, treatment outcome and prognostic factors

To investigate clinical features, treatment outcome and prognostic factors of pediatric supratentorial primitive neuroectodermal tumors(ST-PNETs), 28 ST-PNET cases were retrospectively analyzed. The prognostic importance of age, sex, size of tumor, M stage, extent of surgical resection, histological features, immunohistochemical labelling indices (Ki-67, p53), and apoptotic index were assessed. The mean age at diagnosis was 6.8 years, and the male-to-female ratio was 18:10. The presenting symptoms in 22 cases were increased intracranial pressure and focal neurological deficits. Gross total resection was achieved in 17 cases, near-total (>90%) resection in 3, and subtotal in 7; biopsy was performed in 1 case. The mean duration of follow-up was 37 months. For 25 patients who completed planned adjuvant therapy, the 3-year survival rate was 73%. Univariate analysis showed that the presence of tumor necrosis (P=0.002) and extent of resection (P=0.04) correlated with survival. Patients with a high Ki-67 labelling index (>10%) tended to have shorter survival (P=0.095). In multivariate analysis, tumor necrosis showed statistical significance(P=0.03).

Congenital intraorbital optic nerve cyst. Case report

Congenital cystic lesions of the optic nerve are exceedingly rare; only one case is reported in the world literature. The authors describe a case of congenital simple glial cyst in the intraorbital portion of the optic nerve with a brief review of the literature and comment on its histogenesis. A 45-day-old male infant was admitted to the hospital because of progressive proptosis and hypotropia in the left eye, which had been present since birth. Magnetic resonance imaging of the left orbit revealed an ovoid, well-demarcated, homogeneous cystic mass in the intraconal retrobulbar area. The mass compressed the left eyeball with downward and lateral displacement. The wall of the cystic mass was very thin, and a needle puncture of the cyst released clear, colorless, watery fluid. The cystic wall was lined by loose astroglial nerve fibers with some scattered glial cells.

Neurenteric cyst: its various presentations

Neurenteric (NE) cyst is an uncommon developmental lesion lined with epithelium of endodermal origin. To investigate the clinical manifestation and response to surgery, we retrospectively analyzed eight cases of NE cyst that has been confirmed by surgery. Four were in children. The duration of follow-up ranged from 2 to 105 (mean 38) months. One cyst was in the ventral portion of the posterior cranial fossa and the other seven were on the spinal cord. The chief complaints were motor weakness (5), pain (2), and voiding difficulty (1). In one child and three adults, the duration of symptoms was more than 3 years. Children tended to show rapid progression and excellent recovery after surgery. Although total removal of cyst was possible only in two cases, there was no recurrence. The presentation of an NE cyst may be insidious. Clinical suspicion is important for an early diagnosis and better outcome. Because of the benign course after subtotal excision, too-aggressive removal of the lesion should be avoided.

Sequential change of MR signal intensity of the brain after manganese administration in rabbits. Correlation with manganese concentration and histopathologic findings

RATIONALE AND OBJECTIVES

High signal intensity in the basal ganglia on T1-weighted MR imaging has been reported in chronic manganese (Mn) poisoning. However, the exact meaning of the high signal intensity remains unclear: does it result from Mn itself, secondary pathologic changes of the brain tissue, or both? The goal of this study was to evaluate the sequential change of MR signal intensity and to correlate the MR intensity of the globus pallidus and the hypothalamus with the Mn concentration in the blood and the brain tissue, and with the histopathologic findings.

METHODS

Ten milligrams per kilogram of Mn was administered once a week for 4 weeks to 14 rabbits. The rabbits in the control group (n = 2) were killed without Mn administration; those in group I (n = 4) were killed 1 day after the completion of Mn administration, those in group II (n = 4) were killed at 4 weeks, and those in group III (n = 6) were killed at 8 weeks. Sequential MR imaging, blood and tissue concentration measurement, and pathologic examination were performed. Sequential changes of the percent contrasts, contrast-to-noise ratios, and T1 relaxation times were analyzed with blood and tissue concentrations and histopathologic findings.

RESULTS

The signal intensity of the basal ganglia on T1-weighted imaging was highest 1 day after cessation of Mn administration and sequentially washed out. The contrast, contrast-to-noise ratio, and T1 relaxation time showed significant correlations with blood concentration. Only the T1 relaxation time of the globus pallidus showed a significant correlation with tissue concentration. Histopathologic examination disclosed mild abnormalities in the globus pallidus, thalamus, and hypothalamus.

CONCLUSIONS

The high signal intensity on T1-weighted MR imaging presumably indicates mainly the exposure marker of Mn, although mild pathologic findings were observed.

Solid mesenchymal hamartoma of the liver in adult

This paper presents an unusual solid mesenchymal hamartoma of the liver (MHL) in adult. A well defined solid mass in the left lobe of the liver was found in a 57-year-old female. Preoperative radiologic examinations demonstrated solid mass with multifocal calcifications abutting the gallbladder. By light microscopy, the lesion was composed of dense fibrous stroma with hyalinization, bile ducts and thick-walled vessels without hepatocytes. The solid and hyalinized mesenchymal component would suggest an unusual degenerative change representing a burnt-out MHL.

Gliosarcoma: a case with unusual epithelial feature

Astrocytic tumors, particularly gliosarcoma, may contain epithelial features in the form of trabecular, adenoid, papillary arrangement, and squamous metaplasia. A case of gliosarcoma with unusual epithelial feature is described. The patient was a 60-year-old male with frequent seizures. The mass was 4 cm and in the left frontal lobe. Trabecular or rarely adenoid arrangement of neoplastic astrocytes was present in the mucinous stroma, and there was a distinctive transition between the trabecular area and typical anaplastic astrocytoma. The tumor cells in the trabecular area showed positive immunostain for glial fibrillary acidic protein, but did not react with various kinds of cytokeratin. The sarcomatous area was undifferentiated and was not labeled by factor-VIII, desmin, and anti-smooth muscle actin. Occurrence and histogenesis of epithelial features in gliosarcoma are reviewed. The importance to recognize the existence of epithelial feature in malignant astrocytic tumor is emphasized.

A pathologic study of abdominal lymphangiomas

Abdominal lymphangiomas are uncommon angiomatous tumor occurring mainly in childhood. This is a retrospective clinicopathologic study of 17 cases of abdominal lymphangioma. The patients included are five children and 12 adults, with a mean age at initial presentation of 30.7 years (age ranges 3-63). The locations of the tumors were mesentery (5), retroperitoneum (4), colon (3), omentum (3), mesocolon (1) and gallbladder (1). Infiltrative growth was more common pattern than entirely circumscribed pattern. Masses were mostly multilocular cysts and contained chyle or serous fluid. On immunohistochemical staining, 16 cases were reactive for either CD31 or factor VIII-related antigen. These fact would suggest that intra-abdominal lymphangiomas simulate the immunohistochemical features of collecting lymphatics. Follow up was possible in 12 cases for 3-50 months (mean 19 months) and only one patient showed local recurrence. Although abdominal lymphangiomas are rare in adulthood and correct preoperative diagnosis is difficult, awareness of such a possibility in adulthood will contribute to make a correct preoperative diagnosis.

Reduced expression of CD99 and functional disturbance in anencephalic cortical thymocytes

In a significant proportion of cases, anencephaly is associated with thymic enlargement, suggesting a possibility that anencephalic fetuses have a functional disturbance in thymocyte differentiation and development. In this report, we demonstrated that CD99 expression was consistently reduced in cortical thymocytes of all anencephalic fetuses. In addition, the CD99-dependent aggregation of immature cortical thymocytes was almost completely impaired and apoptosis of thymocytes was markedly reduced in several cases. These results are in agreement with previous findings that CD99 regulates the aggregation and apoptosis of various types of cells. These data strongly suggest that functional disturbance of thymocytes and thymic hyperplasia are related to the reduced expression of CD99 molecule in anencephalic fetuses.

Cardiac laterality and ventricular looping in retinoic acid-treated rat embryos

To determine the ventricular looping pattern in relation to cardiac laterality, we studied rat embryos treated with retinoic acid (RA). A total of 243 Wistar rat embryos from an in vivo treated group (a single dose of 20-40 mg/kg all-trans RA administered to pregnant rats on day 6.5 to 9.5) and 29 control embryos were examined on day 13 of gestation. Twenty-nine embryos from the in-vitro treated group (treated by all-trans RA at 2 x 10(-7) M for 6 hr on day 9.0 or 9.5 during the entire embryo culture for 72 hr) and seven control embryos were examined on day 12 of gestation. Abnormalities in cardiac laterality and ventricular looping were found in the in-vivo groups treated on day 8.5 and 8.75 and in the in-vitro group on day 9.0. Among 25 animals with abnormal laterality, right isomerism was the most common feature (22 cases), while the type of ventricular looping varied. Cases with normal laterality had a low incidence of abnormal looping (1.4%). In rat embryos treated with all-trans RA, normal cardiac looping was expected when cardiac laterality was normal. But in cases with abnormal laterality, the type of abnormal ventricular looping was unexpected.

Proliferation not apoptosis as a prognostic indicator in retinoblastoma

The balance between proliferation and cell death is the major determinant of tumour growth. We analysed the proliferative and apoptotic indices (PI and AI, respectively) of 33 children with retinoblastoma. PI and AI were assessed by immunohistochemistry for Ki-67 antigen and TUNEL staining, respectively. The mean PI was 21.0+/-21.1%, and higher PI was associated with more advanced tumour stage (P<0.0001) and poor clinical outcome (P<0.05). Patients in whom amplified N-myc oncogene was found (n=6) determined by the multiplex polymerase chain reaction tended to have a higher PI (37.6+/-27.2%) than those without amplified N-myc (n=27; PI=17.3+/-18.1). A PI value of over 40% was clearly associated with an unfavourable prognosis. The AI, however, did not correlate with any of the other variables analysed. The findings suggest that proliferation, but not apoptosis, is of critical significance in retinoblastoma biology. PI, as determined by the Ki-67 antigen labelling index, seems to be a relevant histopathological parameter that can predict the clinical outcome of retinoblastoma.

Congenital glioblastoma diagnosed by fetal sonography

Congenital brain tumors are very rare, and 2-9% of them are accounted for by glioblastomas. We encountered a case of congenital glioblastoma detected at the 39th week of gestation by fetal sonography, which revealed a large echogenic mass in the left temporo-parietal area of the fetal brain with significant midline shift and dilatation of the contralateral lateral ventricle. A detailed sonogram obtained 7 h later showed that the mass had increased in size, and this suggested an expanding hematoma. An emergency cesarean section was performed. Postnatal MRI demonstrated an enhancing mass with a large hematoma. Biopsy revealed a malignant brain tumor. Further management was refused and the boy died 6 days after birth. The postmortem pathological diagnosis was glioblastoma. When fetal sonography demonstrates an echogenic mass, a congenital brain tumor should be considered. The mode of delivery should be determined by the nature of the mass and the condition of the fetus.

Engagement of CD99 induces apoptosis through a calcineurin-independent pathway in Ewing's sarcoma cells

Programmed cell death (PCD) is a prominent feature of the development of the immune and nervous systems. In both systems, widespread PCD occurs in primitive progenitor cells during development. In this study, we demonstrated that Ewing's sarcoma (ES) cells, undifferentiated neural precursors, underwent apoptosis upon engagement of CD99 with anti-CD99 monoclonal antibody. Apoptosis via CD99 occurred only in the undifferentiated state of ES cells, but not in differentiated ES cells. CD99-induced apoptosis in ES cells appeared to require de novo synthesis of RNA and protein as well as caspase activation. Cyclosporin A, known to be a potent inhibitor of both calcineurin activation and mitochondrial permeability transition pore opening, inhibited CD99-mediated apoptosis, whereas FK-506, a specific calcineurin inhibitor, did not, indicating the induction of CD99-mediated apoptosis through a calcineurin-independent pathway. Furthermore, the dying cells displayed the reduction of mitochondrial transmembrane potential (delta psi m). These results suggest that CD99 engagement induce CsA-inhibitable mitochondrial permeability transition pore opening, followed by a reduction of delta psi m and caspase activation, thereby leading to apoptosis. Based on these results, we suggest the possible involvement of CD99 in the apoptotic processes that occur during nervous system development and also its application in immunotherapeutic trials for ES cases.

Gliomatosis cerebri: clinical features, treatment, and prognosis

To clarify clinical features and to elucidate prognostic factors and prognosis, the authors retrospectively analyzed 16 cases of gliomatosis cerebri treated at Seoul National University Hospital between January 1988 and December 1995. Age at diagnosis ranged from 19 to 62 (median 34) years and male to female ratio was 10:6. Most presented with headache or seizure, and the mean duration of symptoms was 12.8 months. A poorly defined diffuse high signal intensity lesion, extending in T2-weighted images for two lobes or more, was the characteristic magnetic resonance (MR) image finding. On postcontrast T1-weighted MR imaging, focal enhancement of the lesion was detected in five cases. All patients underwent histological confirmation by craniotomy (9 cases) or stereotactic biopsy (7 cases). Histologically, all patients had compatible findings of gliomatosis cerebri which are the widespread infiltration of neoplastic glial cells with minimal destruction of pre-existing structures. After histological diagnosis, external radiation therapy was begun except in one case, who declined this treatment. Fourteen patients completed the whole procedure and received the planned dose (mean 5780 cGy). Median survival time after diagnosis was 38.4 months. In univariate analysis, the Ki-67 labelling index (> 1) showed significant correlation with the length of survival (p = 0.006). It is suggested that 1) gliomatosis cerebri can be diagnosed by a combination of MR imaging findings and histological examination; 2) histological diagnosis and external radiation therapy might be a good treatment modality; 3) the Ki-67 labelling index correlates significantly with survival time.

Histotopographic distribution of placental inflammation: analysis of 22 cases

Twenty-two placentas were investigated for the presence and patterns of inflammation by extensive examination, and divided into four groups: 1) term vaginal delivery [group I; n=6]; 2) term cesarean section delivery [group II; n=5]; 3) preterm vaginal delivery [group III; n=4], and 4) preterm cesarean section delivery [group IV; n=7]. In group I, all had deciduitis, and choriodeciduitis/ chorionitis was present in two cases (33.3%). In group II, four cases (80%) showed deciduitis and/or choriodeciduitis/chorionitis; three of these had intact membranes. In group III, three cases (75%) showed deciduitis, and two had chorionitis. In group IV, three cases (42.9%) showed no evidence of inflammation, three had deciduitis and one had deciduitis/chorioamnionitis. In all groups, membranitis was more severe, confined to the inner and mid segments in general, and deciduitis, choriodeciduitis/chorionitis and chorioamnionitis tended to overlap. The study newly demonstrates major characteristics of placental inflammation: higher prevalence and severity of inflammation in the inner segments of membrane and at the periphery of the placenta. Taking this histotopography into account, it is desirable to take sections from the placental margin, and the current concept of placental inflammation as a surrogate marker of intrauterine infection should be reevaluated.

Overexpression of cyclin D1 and cdk4 in tumorigenesis of sporadic hepatoblastomas

Abnormality of the cyclin D1/cdk4/p16INK4a/pRb pathway during tumorigenesis has recently been reported. Hepatoblastoma is a rare malignant liver tumor of childhood, but underlying abnormalities of cell-cycle regulating protein remain to be elucidated. The expression of cyclin D1, cdk4, p16 and retinoblastoma gene product (pRb) was studied by immunohistochemistry in 17 paraffin-embedded tissues consisting of both tumor and corresponding non-neoplastic tissues. Tumor tissues showed overexpression of cyclin D1 (13/17, 76%) and cdk4 (15/17, 88%). Eleven cases showed co-overexpression of both cyclin D1 and cdk4. No abnormal p16 or pRb expression was noted. In the group with a high score (+4) for cyclin D1 expression, a positive correlation with tumor recurrence was noted (P = 0.043). These data suggest that overexpressed cyclin D1 and cdk4 protein might play an important role in the tumorigenesis of hepatoblastoma and that in the group with high cyclin D1 expression, tumor recurrence may be more frequent.

Cytokinetic pattern in the thoracic spinal cord of chick embryos (incubation day 5-13) using PCNA staining and TUNEL method

For the cytokinetic studies using spinal cords of chick embryos, chronological patterns of cell proliferation and programmed cell death (apoptosis) should be known. Information in the early stages of chick embryos is available while data on later stages are seldom available. To investigate the chronological patterns of cell proliferation and apoptosis in the thoracic spinal cord of normal chick embryos on incubation day 5, 6, 8, 10 and 13 (Hamburger and Hamilton stage 26-40), proliferating cell nuclear antigen (PCNA) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method were used. Cell proliferation was active at the germinal layer on days 5 and 6. It markedly declined on day 8 and became negligible on day 13. TUNEL-positive cells were mainly found in the germinal layer, the ventrolateral part of the mantle layer and the dorsal root ganglion. Compared to PCNA-positive cells, TUNEL-positive cells were sparse, especially after day 10, when only a few positive cells were scattered. These results will be used as a control data for the studies such as an experimental research for neural tube defects.

Temporal lobe epilepsy caused by intrahippocampal calcified cysticercus: a case report

The major differential diagnoses of epilepsy associated with small solitary lesion are tuberculous or cysticercus granuloma which are enhanced in CT and/or MRI study. We report of a 47-year-old man with intractable temporal lobe epilepsy as the presenting feature of a solitary intrahippocampal calcified mass without enhancement, which turned out to be a Taenia solium cysticercus. There was no apparent evidence of systemic cysticercosis. Imaging studies revealed a small solitary intrahippocampal calcification without perilesional enhancement, and atrophy of the hippocampal head portion. Cysticercosis should be considered as an etiology in the differential diagnosis in lesional medial temporal lobe epilepsy even without perilesional enhancement.