Abstract: Objective Craniocerebral vegetal foreign body granuloma is rare lesion which is very difficult to diagnose clinically, and is easy to be misdiagnosed. This article aims to reveal the clinical manifestations and histopathological features of it.  Methods  A case of cerebral vegetal foreign body granuloma was reported focusing on the following aspects: clinical manifestations, histopathological features and immunophenotype and the relevant literature was reviewed.  Results  A 23-year-old male patient presented with paroxysmal stiffness accompanied by convulsion of extremities and no response for calling for 7 years. Cranial MRI scan demonstrated a small nodular mixed signal shadow about 1.60 cm in length located in the frontal cortex under the anterior horn of the left compartment with gliosis near frontal lobe. A resection was performed, and a lesion (about 3 cm × 2 cm) was found in the bottom of the left frontal lobe. The lesion was greyish brown, tenacious, irregular bordered, partly calcified and with rich blood supply. There was no tumor or parasite but proliferation of fibrous tissue, hyaline degeneration, calcification, infiltration of lymphocytes and plasma cells in the granuloma lesion under microscope. The immunohistochemical staining showed the lesion was positive for vimentin (Vim) and CD68, while negative for glial fibrillary acidic protein (GFAP), S-100 protein (S-100) and epithelial membrane antigen (EMA).  Conclusion  Clinical manifestations of craniocerebral vegetal foreign body granuloma are various according to the occurrence in different parts. Besides, its imaging features are various depending on the kind of foreign body and the persistent duration. However, histopathological observation and immunohistochemical staining facilitate its diagnosis and identification from tumor and parasitic disease. Furthermore, the type of plant can also be distinguished roughly.

Key words: Granuloma, foreign-body, Plants, Brain injuries, Immunohistochemistry, Pathology

摘要： 目的 颅内植物性异物肉芽肿临床十分罕见，对其临床表现和组织病理学特征进行探讨，避免误诊。方法与结果 报告1 例颅内植物性异物肉芽肿患者的临床表现、组织病理学特征和免疫表型，并复习相关文献。男性患者，23 岁。主要表现为发作性四肢强直性抽搐，病程7 年。头部MRI 检查显示，左侧侧脑室前角前下方额叶皮质内长约1.60 cm 的小结节状混杂信号影，邻近额叶组织有胶质化表现。术中可见左侧额底病灶与硬脑膜粘连，大小约为3 cm × 2 cm，呈灰褐色，质地较韧，边界不清，部分钙化，血供丰富。光学显微镜观察显示，肉芽肿伴纤维组织增生、透明变性、钙化及淋巴细胞、浆细胞浸润，未见肿瘤细胞及寄生虫病变；病变组织表达波形蛋白和CD68，不表达胶质纤维酸性蛋白、S-100蛋白和上皮膜抗原。结论 颅内植物性异物肉芽肿根据其部位不同临床表现多样，根据异物种类及存留时间的长短，其影像学也存在多样性，但是可以通过组织病理学和免疫组织化学检测明确诊断，与肿瘤、寄生虫病变相鉴别，并初步明确其植被类型。

关键词: 肉芽肿, 异物, 植物, 脑损伤, 免疫组织化学, 病理学