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Cheng L, Zhu H, Wang J, Wang G, Ma X, Zhao K, Wang J, Shu K. Clinical Features, Diagnosis, and Treatment of Primary Intraventricular Lymphoma: Insights From a Monocentric Case Series. Front Neurol 2022; 13:920505. [PMID: 35734472 PMCID: PMC9207404 DOI: 10.3389/fneur.2022.920505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Primary ventricular lymphoma (PVL) is an extremely rare and commonly misdiagnosed disease. Previous studies were predominantly case reports, and literature regarding the diagnosis and treatment of PVL is limited. Therefore, this study aimed to evaluate the characteristics of patients with PVL. Methods The data of patients with pathologically confirmed PVL were assessed. Epidemiological data, imaging findings, surgery, pathological results, and prognosis were retrospectively analyzed. A systematic review of relevant literature was also conducted. Results A total of eight patients with PVL were identified. The main symptom was increased intracranial pressure. Radiographically, five patients had single lesion and three had multiple lesions; typical findings on magnetic resonance imaging included hypointensity on T1- and T2-weighted imaging, adjacent brain edema, and homogeneous enhancement on contrast-enhanced T1-weighted images. Preoperatively, six cases were misdiagnosed and two cases did not get a definite diagnosis. Craniotomy was performed on all patients, and four achieved gross total resection. Hydrocephalus was relieved after surgical resection in four patients. Pathology revealed diffuse large B-cell lymphoma in all patients. Only one patient had a severe complication. A total of three patients received concomitant adjuvant treatment, whereas five patients refused any adjuvant therapy. At the time of follow-up, the median survival time of patients was 15 months. Conclusion Primary ventricular lymphoma mainly presented with symptoms of increased intracranial pressure and had several imaging characteristics for the diagnosis, but the condition still tends to be misdiagnosed. Surgical resection is a feasible treatment for patients with isolated nodules, especially those with acute obstructive hydrocephalus.
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Yuen CA, Mastrianni J, Ali S, Pytel P, Park DM, Rezania K. An atypical presentation of primary central nervous system lymphoma: A case report. Medicine (Baltimore) 2020; 99:e22062. [PMID: 32957327 PMCID: PMC7505306 DOI: 10.1097/md.0000000000022062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Primary central nervous system lymphoma (PCNSL) involving the choroid plexus is exceedingly rare. The differential diagnosis for choroid plexus enhancing lesions in addition to lymphoma includes infections, sarcoidosis, tuberculosis, papilloma, meningioma, subependymoma, and metastatic lesions. PATIENT CONCERNS A 71-year-old man presented with 3 days of episodic memory loss and gait disturbance. Brain magnetic resonance imaging showed homogenously enhancing lesions with mildly restricted diffusion and T2 hypointensity in the lateral ventricles, as well as T2 hyperintensity and enhancement in the right hippocampus. His episodic memory loss was thought to be secondary to subclinical focal seizures, supported by EEG revealing right temporal lobe epileptiform discharges. DIAGNOSES Large B-cell lymphoma, nongerminal center type was revealed on pathological examination. INTERVENTIONS Stereotactic biopsy of his right thalamic lesion was performed. OUTCOMES The patient underwent induction therapy with high-dose methotrexate, temozolomide, and rituximab, which resulted in complete resolution of the enhancing lesions. He then underwent conditioning chemotherapy with carmustine and thiotepa, followed by autologous stem cell transplantation. His PCNSL remains in remission 42 weeks after the onset of symptoms. LESSONS We report a patient with multifocal PCNSL involving the choroid plexus, who presented with abnormal gait and episodic confusion and memory loss. PCNSL should be considered in the differential diagnosis of acute encephalopathy among immunocompetent older individuals who have choroid plexus enhancing lesions.
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Affiliation(s)
- Carlen A. Yuen
- University of Chicago, Department of Neurology, Chicago, IL
| | | | - Saad Ali
- University of Chicago, Department of Radiology, Chicago, IL
| | - Peter Pytel
- University of Chicago, Department of Pathology, Chicago, IL
| | - Deric M. Park
- University of Chicago, Department of Neurology, Chicago, IL
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3
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Yang J, Liu Z, Yang Y, Chen H, Xu J. Lateral intraventricular primary central nervous system lymphoma (LIPCNSL): a review. QJM 2020; 113:457-464. [PMID: 31899520 DOI: 10.1093/qjmed/hcz330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/23/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lateral intraventricular primary central nervous system lymphoma (LIPCNSL) is an extremely rare intraventricular tumor with high malignancy and has never been systematically described. AIM To analyze the clinical characteristics and therapeutic strategy of LIPCNSL. DESIGN Single-center retrospective study. METHODS The clinical manifestation, imaging, treatment and outcomes of 13 patients with LIPCNSL who underwent craniotomy in West China Hospital between December 2008 and April 2018 were retrospectively analyzed. RESULTS Eleven male and two female patients were enrolled. The mean age was 49.7 years (14-65 years). The frequent manifestations include symptoms of raised intracranial pressure and limb weakness. The mean duration was 1.8 months (1 week to 1 year). The average maximal diameter of tumors was 4.1 cm (1.8-6.1 cm). Gross total resection was achieved in 84.6% of patients. Symptoms improved in 69.2% of patients but developed in 30.8% of patients after surgery. The median recurrence-free survival (RFS) and overall survival (OS) were 2.0 months (1-86 months) and 3.0 months (1-124 months). High-dose methotrexate or/and radiotherapy significantly prolonged the RFS and OS (P < 0.05). Eight patients (72.7%) experienced relapse and progression. Salvage treatment significantly prolonged survival after relapse (P < 0.05). CONCLUSIONS LIPCNSL should be considered as a differential diagnosis of intraventricular tumors. High-dose methotrexate-based chemotherapy with or without radiotherapy should be the first-line treatment, and surgery is only for biopsy and improving symptoms. Long-term intensive follow-up is necessary and active salvage treatment should be performed after relapse.
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Affiliation(s)
- J Yang
- Department of Neurosurgery, West China Hospital, Guoxue Street 37
| | - Z Liu
- Department of Neurosurgery, West China Hospital, Guoxue Street 37
| | - Y Yang
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Chengdu, Sichuan 610041, P. R. China
| | - H Chen
- Department of Neurosurgery, West China Hospital, Guoxue Street 37
| | - J Xu
- Department of Neurosurgery, West China Hospital, Guoxue Street 37
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Solár P, Zamani A, Kubíčková L, Dubový P, Joukal M. Choroid plexus and the blood-cerebrospinal fluid barrier in disease. Fluids Barriers CNS 2020; 17:35. [PMID: 32375819 PMCID: PMC7201396 DOI: 10.1186/s12987-020-00196-2] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/22/2020] [Indexed: 01/08/2023] Open
Abstract
The choroid plexus (CP) forming the blood-cerebrospinal fluid (B-CSF) barrier is among the least studied structures of the central nervous system (CNS) despite its clinical importance. The CP is an epithelio-endothelial convolute comprising a highly vascularized stroma with fenestrated capillaries and a continuous lining of epithelial cells joined by apical tight junctions (TJs) that are crucial in forming the B-CSF barrier. Integrity of the CP is critical for maintaining brain homeostasis and B-CSF barrier permeability. Recent experimental and clinical research has uncovered the significance of the CP in the pathophysiology of various diseases affecting the CNS. The CP is involved in penetration of various pathogens into the CNS, as well as the development of neurodegenerative (e.g., Alzheimer´s disease) and autoimmune diseases (e.g., multiple sclerosis). Moreover, the CP was shown to be important for restoring brain homeostasis following stroke and trauma. In addition, new diagnostic methods and treatment of CP papilloma and carcinoma have recently been developed. This review describes and summarizes the current state of knowledge with regard to the roles of the CP and B-CSF barrier in the pathophysiology of various types of CNS diseases and sets up the foundation for further avenues of research.
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Affiliation(s)
- Peter Solár
- Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic
- Department of Neurosurgery, Faculty of Medicine, Masaryk University and St. Anne´s University Hospital Brno, Pekařská 53, CZ-656 91, Brno, Czech Republic
| | - Alemeh Zamani
- Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic
| | - Lucie Kubíčková
- Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic
| | - Petr Dubový
- Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic
| | - Marek Joukal
- Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, CZ-625 00, Brno, Czech Republic.
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Epstein-Barr Virus-Induced Post-Transplant Lymphoproliferative Disorder of the Central Nervous System Successfully Treated with Chemo-immunotherapy. Viruses 2020; 12:v12040416. [PMID: 32276450 PMCID: PMC7232501 DOI: 10.3390/v12040416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022] Open
Abstract
Aplastic anemia is a rare blood disease characterized by the destruction of the hematopoietic stem cells (HSC) in the bone marrow that, in the majority of cases, is caused by an autoimmune reaction. Patients with aplastic anemia are treated with immunosuppressive drugs and some of them, especially younger individuals with a donor available, can be successfully treated with hematopoietic stem cell transplantation (HSCT). We report here a rare case of post-transplant lymphoproliferative disorder (PTLD) associated with Epstein–Barr virus (EBV) reactivation in a 30-year-old female patient who underwent allogeneic HSCT for severe aplastic anemia. The PTLD, which was diagnosed 230 days after transplantation, was localized exclusively in the central nervous system (specifically in the choroid plexus) and manifested with obvious signs of intracranial hypertension. After receiving three cycles of high dose methotrexate (HD-MTX) combined with rituximab, the patient achieved a complete clinical recovery with normalization of blood cell counts, no evidence of EBV reactivation, and no associated neurotoxicity.
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Kumar H, Sharma A, Sharma V, Singhvi S. Primary Central Nervous System Lymphoma Involving Entire Ventricular System. Asian J Neurosurg 2020; 15:126-127. [PMID: 32181185 PMCID: PMC7057909 DOI: 10.4103/ajns.ajns_94_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/29/2017] [Indexed: 01/20/2023] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is a rare tumor that accounts for <1%–4% of primary CNS tumor.[1] PCNSLs are class of non-Hodgkin's lymphomas which are primarily of diffuse large B-cell origin (90%), with remaining being T-cell lymphoma (10%). Author report a rare case of PCNSL presenting as an intracranial mass involving the entire ventricular system, in an immunocompetent 36-year-old male with severe headache, decreased vision, and unsteady gait. The diagnosis was obtained by histopathological and subsequent immunohistochemistry.
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Affiliation(s)
- Hemant Kumar
- Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Achal Sharma
- Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Vinod Sharma
- Department of Neurosurgery, S.M.S. Medical College, Jaipur, Rajasthan, India
| | - Shashi Singhvi
- Department of Pathology, Patho Care and Research Centre, S.M.S. Medical College, Jaipur, Rajasthan, India
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Ventricle-predominant primary CNS lymphomas: clinical, radiological and pathological evaluation of five cases and review of the literature. Brain Tumor Pathol 2019; 37:22-30. [DOI: 10.1007/s10014-019-00354-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/04/2019] [Indexed: 12/11/2022]
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Kayatani H, Nitta N, Moritani S, Nozaki K. Primary diffuse large B-cell lymphoma of the choroid plexus: A case report and review of the literature. Surg Neurol Int 2018; 9:110. [PMID: 29930876 PMCID: PMC5991284 DOI: 10.4103/sni.sni_289_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 04/12/2018] [Indexed: 11/04/2022] Open
Abstract
Background Primary lymphomas in the choroid plexus are much less frequent than primary lymphomas in the brain parenchyma. Case Description A 66-year-old male patient was referred to our department with a right intraventricular mass that had been diagnosed by biopsy at another hospital as anaplastic ependymoma. The patient underwent subtotal removal of the tumor via a transcortical inferior temporal gyrus approach. The mass was attached to the choroid plexus in the right atrium. Histopathological examination showed diffuse large B-cell lymphoma. Ophthalmological examination, blood tests, computed tomography of the whole body, and bone marrow biopsy did not show any other lesion, leading to the diagnosis of primary choroid plexus lymphoma. The patient underwent chemotherapy with three courses of high-dose methotrexate and one course of carboplatin and etoposide followed by whole-brain irradiation (1.8 Gy × 22). Conclusion We present a rare case of primary choroid plexus lymphoma, which should be considered in the differential diagnosis of choroid plexus tumors.
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Affiliation(s)
- Hitoshi Kayatani
- Department of Neurosurgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, Japan
| | - Naoki Nitta
- Department of Neurosurgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, Japan.,National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Aoi-ku, Shizuoka, Japan
| | - Suzuko Moritani
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, Japan
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu, Shiga, Japan
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Qin JZ, Wu YK, Yang ZJ, Lv J, Dang YY, Zhang HT, Dai YW. Endoscopic biopsy of a B-cell lymphoma involving the entire ventricular system: A case report. Exp Ther Med 2015; 11:325-327. [PMID: 26889262 DOI: 10.3892/etm.2015.2861] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 05/06/2014] [Indexed: 11/06/2022] Open
Abstract
A 62-year-old male suffering from vomiting and mild preceding nausea for 15 days was examined in the present case report. Magnetic resonance imaging revealed a homogeneously enhancing cluster-like lesion involving the lateral, third and fourth ventricles. An endoscopic biopsy was performed, and histopathological examination led to the diagnosis of a high-grade diffuse large B-cell lymphoma. To the best of our knowledge, the present study reports the first case of a primary lymphoma involving the entire ventricular system. Therefore, primary lymphomas should be considered in the list of ventricular tumors. An endoscopic biopsy requires minimal invasion to obtain an adequate tissue sample, and frequently leads to the correct diagnosis and subsequent treatment protocols.
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Affiliation(s)
- Jia-Zhen Qin
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Yue-Kui Wu
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Zhi-Jun Yang
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Jun Lv
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Yuan-Yuan Dang
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Hong-Tian Zhang
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
| | - Yi-Wu Dai
- The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA, Beijing 100700, P.R. China; Neurosurgical Institution of Beijing Military Region PLA, Beijing 100700, P.R. China
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To CY, Rajah G, Klein E, McNaughton M, Ham S, Haridas A, Kupsky W, Marin H, Sood S. Desmoplastic infantile ganglioglioma with associated giant aneurysm—case report. Childs Nerv Syst 2015; 31:1413-8. [PMID: 25922053 DOI: 10.1007/s00381-015-2722-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 04/20/2015] [Indexed: 11/26/2022]
Abstract
Desmoplastic infantile ganglioglioma (DIG) and supratentorial giant cerebral aneurysm are each extremely rare entities in infants. Here, we present the case of an 8-day old boy who had both of these conditions concurrently. To our knowledge, there is no previous case reported of a patient with coexisting DIG and giant aneurysm.
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Affiliation(s)
- Chiu Yuen To
- Department of Neurosurgery, Detroit Medical Center, Wayne State University, Detroit, MI, USA,
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Cheatle JT, Aizenberg MR, Weinberg JS, Surdell DL. Atypical presentation of primary central nervous system non-Hodgkin lymphoma in immunocompetent young adults. World Neurosurg 2012; 79:593.e9-13. [PMID: 22885166 DOI: 10.1016/j.wneu.2012.07.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 03/30/2012] [Accepted: 07/20/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Primary central nervous system non-Hodgkin lymphoma (PCNSL) is a malignant lymphoma limited to the cranial-spinal axis in the absence of systemic lymphoma. Historically, PCNSL accounts for fewer than 5% of all cases of primary intracranial neoplasms. PCNSL is rare in immunocompetent young adults. Although the prognosis for PCNSL is poor, approximately 20%-30% percent of cases achieve a cure. METHODS We report two cases of PCNSL originating in the ventricle in otherwise healthy immunocompetent young adults. RESULTS A 27-year-old man presented with 10 days of nausea, vomiting, and headache and was found to have a large intraventricular mass emanating from the choroid plexus with resultant hydrocephalus. He underwent placement of external ventricular drain and systemic and intrathecal chemotherapy for cytologically proven PCNSL. A 31-year-old pregnant woman presented with headaches, vision difficulties, and ataxia and was found to have a septum pellucidum mass. She underwent craniotomy and subtotal resection of the mass with subsequent systemic therapy and whole brain radiation for treatment of PCNSL. CONCLUSIONS To our knowledge, this is the first report of primary CNS lymphoma of the choroid plexus and septum pellucidum in otherwise healthy, immunocompetent young adults.
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Affiliation(s)
- Joseph T Cheatle
- Division of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Yakupoglu H, Onal M, Civelek E, Kircelli A, Aygun M, Aygun F. Primary diffuse choroid plexus T-cell lymphoma: Case report. J Neuroradiol 2012; 39:116-8. [DOI: 10.1016/j.neurad.2011.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/20/2011] [Accepted: 03/31/2011] [Indexed: 10/18/2022]
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Abstract
Lateral ventricular neoplasms are rare, and account for 50% of all intraventricular tumors in adults and 25% in children. Although these neoplasms are easily detected with computed tomography (CT) and magnetic resonance imaging (MRI), both techniques are relatively unspecific in identifying the type of tumor. However, few imaging patterns are specific for a particular pathological process and useful conclusions can be made from the morphological appearance of the lesion, its location and enhancement pattern. The aim of this article was to review and illustrate the CT and MRI findings of a wide spectrum of tumors of the lateral ventricle. We reviewed choroid plexus tumors, meningioma, subependymal giant cell astrocytoma, central neurocytoma, and less frequent lesion such as lymphoma and metastases.
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Abstract
Stroke is a disabling disease and can add to the burden of patients already suffering from cancer. Several major mechanisms of stroke exist in cancer patients, which can be directly tumour related, because of coagulation disorders, infections, and therapy related. Stroke can also occur as the first sign of cancer, or lead to its detection. The classical literature suggests that stroke occurs more frequently in cancer patients than in the average population. More recent studies report a very similar incidence between cancer and non-cancer patients. However, there are several cancer-specific types and causes of stroke in cancer patients, which need to be considered in each patient. This review classifies stroke into ischaemic, haemorrhagic, cerebral venous thrombosis and other rarer types of cerebrovascular disease. Its aim is to identify the types of stroke most frequently associated with cancer, and give a practical view on the most common and most specific types of stroke. The diagnosis of the cause of stroke in cancer patients is crucial for treatment and prevention. Management of different stroke types will be briefly discussed.
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Affiliation(s)
- W Grisold
- LBI NeuroOncology, KFJ Hospital, Vienna, Austria
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Cecchi PC, Billio A, Colombetti V, Rizzo P, Ricci UM, Schwarz A. Primary high-grade B-cell lymphoma of the choroid plexus. Clin Neurol Neurosurg 2008; 110:75-9. [DOI: 10.1016/j.clineuro.2007.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 07/26/2007] [Accepted: 08/23/2007] [Indexed: 10/22/2022]
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