Fig. 3

MRI (A, B, C) and pathological results (D, E) of a 39-year-old male patient with acute lymphoblastic leukemia (ALL). MRI showed abnormal mixed patchy signals adjacent to the right temporal lobe ventricle (puncture biopsy site), with mixed T1 (A) and long T2 signals (B), surrounding brain tissue edema, and partial enhancement (C). Multiple abnormal signals are observed adjacent to the left lateral ventricular posterior horn, with small circular volumes, short T1 (A) and long T2 signals (B), and surrounding brain tissue edema with ring enhancement (C). Pathologically (D), abundant fungal hyphae are observed between cells, appearing relatively uniform and possibly sharply branched. Silver staining (E) confirms the presence of fungi; Giemsa staining ( −) and acid-fast staining ( −) yielded negative results. Immunohistochemistry results: GFAP (+ + +), Olig2 ( +), P53 (negative), Ki67 (approximately 2% positive), LCA ( +), CD3 (+ + +), CD20 (negative), and CD68 (+ + +). MRI, Magnetic Resonance Imaging; Olig2, Oligodendrocyte transcription factor 2; P53, Tumor Protein 53; GFAP, Glial Fibrillary Acidic Protein; LCA, Leukocyte Adhesion Deficiency