Intracranial Cholesterol Granuloma in a Cat

Abstract

ABSTRACT. A case of intracranial cholesterol granuloma is described in a 4-year-old neutered European male cat presented with a 5-month history of progressive weakness, ataxia and depression. On clinical evaluation, haematological and biochemical profiles revealed only mild hypercholesterolemia and magnetic resonance imaging showed a large space-occupying extra-axial mass in the area of the falx, not homogeneous after contrast enhancement. At post-mortem examination, an orange-yellowish mass of 22 mm in diameter extended from the right frontal lobe to the temporo-parietal region, causing atrophy of the prosencephalic region of the brain. The site of origin of the mass was within the subarachnoid space of the supracallosum sulcus of the right cerebral hemisphere. Histological examination of the lesion revealed abundant deposits of cholesterol clefts, surrounded by clusters of macrophages and multinucleated giant cells. Neither inflammatory lesions, nor cholesterol deposits were detected in other areas of the brain and in other organs. On the basis of the histological examination, a diagnosis of intracranial cholesterol granuloma was made.KEY WORDS: cholesterol granuloma, feline, MRI, nervous system disease.J. Vet. Med. Sci. 72(11): 1475-1478, 2010 Cholesterol granulomas (CGs) are known as well circumscribed, non neoplastic lesions, resulting from a chronic inflammatory reaction to continuous deposition of cholesterol crystals [10]. In human beings, a diagnosis of CG has been established in several sites throughout the body, comprising the intracranial localisation [4,13,20].In veterinary medicine, the development of an intracranial cholesterol granuloma has been described as an incidental, asymptomatic finding at necropsy in 20% of older horses and the choroid plexus of fourth and lateral ventricles represented the preferential location of the so-called "cholesteatoma of the choroid plexus" [9]. Sporadic descriptions of identical intracranial lesions have been reported in other animals, such as meerkats (Suricata suricatta sp., family Herpestidae) [2,21,22] A 4 year-old neutered male cat was presented at the "Malpensa" Veterinary Clinic (Samarate, Italy) with a 5-month history of progressive weakness, ataxia and depression. The cat was previously treated with prednisone with partial remission of clinical signs. On clinical examination, the cat appeared dehydrated and in poor general condition. At presentation the cat exhibited aggressive behaviour and only a limited number of neurological tests could be performed. Neurological examination revealed proprioceptive deficits in all four limbs, no evident abnormality of cranial nerves and a poor bilateral menace reaction. On the basis of the clinical data, a forebrain lesion was suspected. Differential diagnoses included encephalitis, neoplasia, toxic, metabolic or nutritional encephalopathy. Haematological and biochemical profiles revealed moderate hyperglycaemia (343 mg/dl, normal range: 60-175 mg/dl) and mild hypercholesterolemia (236 mg/dl, normal range: 97-207 mg...

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