Choroid Plexus Lesions



Choroid Plexus Lesions


Karen L. Salzman, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Choroid Plexus Cyst


  • Enlarged Choroid Plexus


Less Common



  • Choroid Plexus Papilloma


  • Meningioma


  • Metastasis, Intraventricular


  • Ventriculitis/Plexitis


  • Sturge-Weber Syndrome


  • Neurofibromatosis Type 2


Rare but Important



  • Choroid Plexus Carcinoma


  • Lipoma


  • Langerhans Cell Histiocytosis


ESSENTIAL INFORMATION


Key Differential Diagnosis Issues



  • Most common cause of choroid plexus mass in adults is benign degenerative cyst


Helpful Clues for Common Diagnoses



  • Choroid Plexus Cyst



    • Common incidental finding in older patients (40% prevalence); bilateral


    • In fetus, consider trisomy 18 or 21


  • Enlarged Choroid Plexus



    • Normal in fetus, may be giant


    • May occur after hemispherectomy


    • May occur with collateral venous drainage (i.e., AVM, Sturge-Weber)


Helpful Clues for Less Common Diagnoses



  • Choroid Plexus Papilloma



    • Strongly enhancing, lobulated intraventricular mass in child


    • Atrium of lateral ventricle 50%, left > right


  • Meningioma



    • Solid, enhancing intraventricular mass


    • Origin of intraventricular location related to embryological invagination of arachnoid cells into choroid plexus


  • Metastasis, Intraventricular



    • Enhancing choroid plexus mass


  • Ventriculitis/Plexitis



    • Enhancing ependyma & choroid plexus


    • Ventriculomegaly with debris level


  • Sturge-Weber Syndrome



    • Enlarged, enhancing “angiomatous” ipsilateral choroid plexus


    • May be only finding in first 6 months


    • Related to abnormal fetal cortical veins


  • Neurofibromatosis Type 2



    • Extensive choroid plexus Ca++, uncommon manifestation


Helpful Clues for Rare Diagnoses

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Choroid Plexus Lesions

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