Gradenigo’s Syndrome and Bacterial Meningitis in a Patient with a Petrous Apex Cholesterol Granuloma

Figure 7

Cholesterol granuloma (100X, hematoxylin and eosin stained), also known as a xanthoma or xanthogranuloma, referring to the cholesterol clefts (arrowheads), lipid-laden macrophages, and multinucleated foreign-body giant cells. In addition, these lesions can demonstrate varying amounts of histiocytes, hemosiderin-laden macrophages (arrows), fibrosis, and calcification. Cholesterol granulomas can be locally destructive, but are typically painless lesions that remain subclinical until discovered incidentally.