Dysphagia and Neck Swelling in a Case of Undiagnosed Lhermitte-Duclos Disease and Cowden Syndrome

Figure 3

The surgical resection specimen includes a region of almost normal cerebellar parenchyma (a), with a normal granule cell layer that consists of fairly densely packed small neurons that are seen as blue nuclei separated by synaptic zones that are pink. The normal single layer of large Purkinje cells is located at the interface with the low cellularity molecular layer, here minimally more cellular than usual. Compare this with the images of the lesion (b and c). (b) The cerebellar granule cell layer in this region of the lesion is dysmorphic. Granule cells are scant and dispersed among ganglionic cells of varying sizes that expand this layer. (c) Detail of a region featured in upper right quadrant of panel (b) highlights the variable size of the abnormal ganglionic neurons characterized by relatively abundant cytoplasm and large nuclei with prominent nucleoli, some with abnormal irregularly shaped nuclei, that replace and expand the granule cell layer (hematoxylin and eosin paraffin sections; original magnifications: (a) 100x, (b) 200x, and (c) 400x).

(a)

(b)

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