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Lee MH, Lubner MG, Kennedy TA, Ross A, Gegios A, Mellnick V, Bhalla S, Buehler D, Pickhardt PJ. Multimodality Imaging of Hamartomas: Interactive Case-based Approach. Radiographics 2023; 43:e220127. [PMID: 36862084 DOI: 10.1148/rg.220127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Matthew H Lee
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Meghan G Lubner
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Tabassum A Kennedy
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Andrew Ross
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Alison Gegios
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Vincent Mellnick
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Sanjeev Bhalla
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Darya Buehler
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
| | - Perry J Pickhardt
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (M.H.L., M.G.L., T.A.K., A.R., A.G., P.J.P.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (V.M., S.B.); and Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisc (D.B.)
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Diverse imaging findings of Lhermitte-Duclos disease. Clin Radiol 2023; 78:33-39. [PMID: 36182334 DOI: 10.1016/j.crad.2022.08.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 01/07/2023]
Abstract
AIM To evaluate the diverse clinical and imaging features of Lhermitte-Duclos disease (LDD) and its subgroup comparison. MATERIALS AND METHODS Clinical data from 21 patients with LDD were collected, including eight patients with LDD without other tumours and 13 LDD with other tumours. Redefined diagnostic criteria are used to evaluate Cowden Syndrome. Imaging indicators were analysed retrospectively to extract typical and atypical features. Imaging findings and preoperative diagnostic accuracy were compared between the subgroups. RESULTS None of these patients met the redefined diagnostic criteria. The typical "tiger stripe sign" was seen in most LDD lesions (13/29, 61.9%), with lower density (29.66 ± 2.51 versus 37.81 ± 2.76 HU, p<0.001) and higher apparent diffusion coefficient (ADC) value (1.04 ± 0.05 × 10-3 versus 0.74 ± 0.03 × 10-3 mm2/s, p<0.001) than that of the normal cerebellum. Atypically, some lesions showed abnormal vessels (8/21, 38.1%), intratumoural calcification (3/21, 14.29%), intratumoural haemorrhage (4/21, 19.05%), peritumoural oedema (6/21, 28.57%), and heterogeneous enhancement (5/21, 23.81%). The typical "tiger stripe sign" was more common in LDD with other tumours (84.62% versus 25%, p=0.018). Although LDD without other tumours was more common with abnormal vessels (75% versus 15.38%, p=0.018), intratumoural calcification (37.5% versus 0, p=0.042), intratumoural haemorrhage (50% versus 0, p=0.012), peritumoural oedema (62.5% versus 7.69%, p=0.014) and heterogeneous enhancement (50% versus 7.69%, p=0.047). Preoperative diagnostic accuracy was higher in LDD with other tumours than LDD without other tumours (76.92% versus 25%, p=0.032). CONCLUSION The "tiger stripe sign" of LDD is characteristic, but not unique. With or without other tumours, it may be associated with the imaging diversity. Combining typical and atypical signs can improve the imaging assessment of LDD.
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Lakhani DA, Boo S. Lhermitte-Duclos Disease. Radiology 2022; 307:e221979. [PMID: 36511809 DOI: 10.1148/radiol.221979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Dhairya A. Lakhani
- From the Department of Radiology, West Virginia University, Ruby Memorial Hospital, 1 Medical Center Dr, Morgantown, WV 26506 (D.A.L., S.H.B.); and Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV (S.H.B.)
| | - SoHyun Boo
- From the Department of Radiology, West Virginia University, Ruby Memorial Hospital, 1 Medical Center Dr, Morgantown, WV 26506 (D.A.L., S.H.B.); and Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV (S.H.B.)
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4
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Vaz A, Cavalcanti MS, da Silva Junior EB, Ramina R, de Almeida Teixeira BC. Uncommon Glioneuronal Tumors: A Radiologic and Pathologic Synopsis. AJNR Am J Neuroradiol 2022; 43:1080-1089. [PMID: 35512827 PMCID: PMC9575428 DOI: 10.3174/ajnr.a7465] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/18/2021] [Indexed: 11/07/2022]
Abstract
Glioneuronal tumors are characterized exclusively by neurocytic elements (neuronal tumors) or a combination of neuronal and glial features (mixed neuronal-glial tumors). Most of these tumors occur in young patients and are related to epilepsy. While ganglioglioma, dysembryoplastic neuroepithelial tumor, and desmoplastic infantile tumor are common glioneuronal tumors, anaplastic ganglioglioma, papillary glioneuronal tumor, rosette-forming glioneuronal tumor, gangliocytoma, and central neurocytoma are less frequent. Advances in immunohistochemical and molecular diagnostics have improved the characterization of these tumors and favored the description of variants and new subtypes, some not yet classified by the World Health Organization. Not infrequently, the histologic findings of biopsies of glioneuronal tumors simulate low-grade glial neoplasms; however, some imaging findings favor the correct diagnosis, making neuroimaging essential for proper management. Therefore, the aim of this review was to present key imaging, histopathology, immunohistochemistry, and molecular findings of glioneuronal tumors and their variants.
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Affiliation(s)
- A Vaz
- From the Department of Pediatric Radiology (A.V., B.C.d.A.T.), Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil .,Department of Internal Medicine (A.V., B.C.d.A.T.), Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - M S Cavalcanti
- Department of Pathology (M.S.C.), Neopath Diagnostics & Research Center, Curitiba, Paraná, Brazil
| | | | - R Ramina
- Departments of Neurosurgery (E.B.d.S.J., R.R.)
| | - B C de Almeida Teixeira
- From the Department of Pediatric Radiology (A.V., B.C.d.A.T.), Hospital Pequeno Príncipe, Curitiba, Paraná, Brazil.,Department of Internal Medicine (A.V., B.C.d.A.T.), Universidade Federal do Paraná, Curitiba, Paraná, Brazil.,Neuroradiology (B.C.d.A.T.), Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil
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Bizimana W, Koudouhonon RO, Igombe SRA, Amarkak WA, Benelhosni K, Nassar I, Moatassim NB. A Radiological Curiosity of a Rare Diagnosis: Lhermitte- Duclos Disease. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1748638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
AbstractLhermitte–Duclos disease (LDD) is a rare cerebellar lesion, described in 1920 by two French physicians: Lhermitte and Duclos. The clinical presentation is usually made of neurological symptoms. This lesion is characterized by a hamartomatous lesion in the posterior fossa. Mainly diagnosed by MRI, when it comes to preoperative, the T2-weightened MRI demonstrates the classical “tiger-striped” pattern. The definitive diagnosis, nonetheless, is histopathological. The treatment for LDD consists of surgical decompression or excision. We present here a rare case of a woman who developed neurological symptoms that led to LDD diagnosis to describe protocol MRI imaging, the main findings and their pathophysiological meanings.
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Affiliation(s)
- Wilson Bizimana
- Central Radiology Department, UHC Ibn SINA, Mohamed V. University, Rabat, Morocco
| | - Rita Oze Koudouhonon
- Central Radiology Department, UHC Ibn SINA, Mohamed V. University, Rabat, Morocco
| | | | - Waïs A. Amarkak
- Central Radiology Department, UHC Ibn SINA, Mohamed V. University, Rabat, Morocco
| | - Khadija Benelhosni
- Central Radiology Department, UHC Ibn SINA, Mohamed V. University, Rabat, Morocco
| | - Ittimade Nassar
- Central Radiology Department, UHC Ibn SINA, Mohamed V. University, Rabat, Morocco
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6
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Başoğlu Y, Yilmaz O, Çelik İ, Şerbetçioğlu MB. Role of Long-Term Vestibular Rehabilitation in a Patient with Posterior Fossa Tumor: A Case Report with 2 Years of Follow-Up. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e924262. [PMID: 32915776 PMCID: PMC7508306 DOI: 10.12659/ajcr.924262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 36-year-old Final Diagnosis: Central vestibular disorders • lhermitte duclos • posterior fossa tumor Symptoms: Blurred vision • dizziness • Headache • nausea • nystagmus • postural dizziness • tinnitus • vertigo Medication: — Clinical Procedure: Bedside test • Cawthorne-Cooksey exercises • magnetic resonance imaging • physical examination • vestibular rehabilitation • Video Head Impulse Test • videonystagmography Specialty: Otolaryngology • Rehabilitation
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Affiliation(s)
- Yuşa Başoğlu
- Department of Audiology, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Oğuz Yilmaz
- Department of Audiology, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - İlayda Çelik
- Department of Audiology, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
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Ajithkumar T, Imbulgoda N, Rees E, Harris F, Horan G, Burke A, Jefferies S, Price S, Cross J, Allinson K. Uncommon low-grade brain tumors. Neuro Oncol 2020; 21:151-166. [PMID: 30239861 DOI: 10.1093/neuonc/noy151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The 2016 World Health Organization (WHO) classification of primary central nervous system (CNS) tumors includes numerous uncommon (representing ≤1% of tumors) low-grade (grades I-II) brain neoplasms with varying clinical behaviors and outcomes. Generally, gross tumor or maximal safe resection is the primary treatment. Adjuvant treatments, though their exact role is unknown, may be considered individually based on pathological subtypes and a proper assessment of risks and benefits. Targetable mutations such as BRAF (proto-oncogene B-Raf), TRAIL (tumor necrosis factor apoptosis inducing ligand), and PDGFR (platelet derived growth factor receptor) have promising roles in future management.
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Affiliation(s)
- Thankamma Ajithkumar
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Naduni Imbulgoda
- Department of Oncology, National Cancer Institute, Maharagama, Sri Lanka
| | - Elliott Rees
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Fiona Harris
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Gail Horan
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Amos Burke
- Department of Paediatric Hematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Sarah Jefferies
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Stephen Price
- Department of Neurosurgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Justin Cross
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Kieren Allinson
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
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8
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Gupta S, Swarup MS, Singh S, Prakash A, Mehndiratta A, Garg A. Phakomatoses: A pictorial review. Indian J Radiol Imaging 2020; 30:195-205. [PMID: 33100689 PMCID: PMC7546286 DOI: 10.4103/ijri.ijri_497_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/11/2020] [Accepted: 04/09/2020] [Indexed: 01/13/2023] Open
Abstract
Phakomatoses or Neurocutaneous syndromes are a heterogeneous group of disorders and have variable inheritance pattern. Currently, more than 30 entities are included in this group. These disorders primarily affect the central nervous system; however, skin, viscera, and other connective tissues can also be involved with variable clinical presentation. We will describe and illustrate the various radiological findings of the common entities through the iconography of the cases presented to our department.
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Uchida D, Nakatogawa H, Inenaga C, Tanaka T. An Unusual Case of Lhermitte-Duclos Disease Manifesting with Intratumoral Hemorrhage. World Neurosurg 2018; 114:326-329. [DOI: 10.1016/j.wneu.2018.03.184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/25/2018] [Accepted: 03/26/2018] [Indexed: 11/26/2022]
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10
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11
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Gama I, Almeida L. Lhermitte-Duclos disease associated to Cowden syndrome: de novo diagnosis and management of these extremely rare syndromes in a patient. BMJ Case Rep 2017; 2017:bcr-2016-217974. [PMID: 28137902 DOI: 10.1136/bcr-2016-217974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 36-year-old woman, with history of cutaneous papilomatosis and thyroid carcinoma presented with headache, transitory visual blurring and nausea. Funduscopy showed papilloedema. MRI showed a tumour of the right cerebellar hemisphere with a striated, tigroid pattern, typical of Lhermitte-Duclos disease (LDD). Significant clinical and perimetric improvements were noted after surgery and the follow-up did not reveal recurrences of the tumour. LDD is an extremely rare differential diagnosis of posterior fossa tumours. LDD and the history of thyroid carcinoma permitted us to diagnose Cowden syndrome (CS). We present a clinical case that supports the possibility of performing a preoperative diagnosis of LDD based on MRI features. We review the diagnosis and management of LDD and CS. This report highlights the importance of excluding CS after LDD diagnosis, of monitoring the optic nerve postoperatively using optical coherence tomography and of prompt treatment that can potentially prevent visual function loss.
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Affiliation(s)
- Ivo Gama
- Ophthalmology Department, University Hospital Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal.,Medical Faculty of Lisbon, University of Lisbon, Lisbon, Portugal
| | - Leonor Almeida
- Ophthalmology Department, University Hospital Santa Maria, North Lisbon Hospital Center, Lisbon, Portugal.,Medical Faculty of Lisbon, University of Lisbon, Lisbon, Portugal
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12
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Golden N, Tjokorda MGB, Sri M, Niryana W, Herman S. Management of unusual dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease) in a developing country: Case report and review of the literature. Asian J Neurosurg 2016; 11:170. [PMID: 27057227 PMCID: PMC4802942 DOI: 10.4103/1793-5482.145091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dysplastic cerebellar gangliocytoma or Lhermitte-Duclos disease (LDD) especially in children are extremely rare. In this report we add one further case to this rare entity. A three year old boy with a history of cerebellar and brain stem compression signs was presented in unconscious condition. Computerized tomography (CT) scan revealed a well defined lesion mixed with area of calcification in the right cerebellum and severe obstructive hydrocephalus. Ventricular shunting was performed followed by gross total tumor removal three days after shunting. In the follow up period, the patient showed almost total resolution of all neurological deficits. MRI has been an imaging tool to preoperatively diagnose this disease; otherwise it would be uncertain preoperative diagnosis. However, in this report we would like to emphasize that not all uncertain diagnosis of LDD leads to palliative treatment. Well demarcated lesion may account for the safe surgical resection of this disease.
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Affiliation(s)
- Nyoman Golden
- Department of Neurosurgery, Sanglah General Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Mahadewa G B Tjokorda
- Department of Neurosurgery, Sanglah General Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Maliawan Sri
- Department of Neurosurgery, Sanglah General Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Wayan Niryana
- Department of Neurosurgery, Sanglah General Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Saputra Herman
- Department of Pathology, Sanglah General Hospital, School of Medicine, Udayana University, Denpasar, Bali, Indonesia
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Cotes C, Bonfante E, Lazor J, Jadhav S, Caldas M, Swischuk L, Riascos R. Congenital basis of posterior fossa anomalies. Neuroradiol J 2015; 28:238-53. [PMID: 26246090 DOI: 10.1177/1971400915576665] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies.
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Affiliation(s)
- Claudia Cotes
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Eliana Bonfante
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | | | - Leonard Swischuk
- Department of Radiology, and Pediatric Radiology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Roy Riascos
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, TX, USA
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15
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Gocmen R, Guler E, Kose IC, Oguz KK. Power of the metaphor: forty signs on brain imaging. J Neuroimaging 2015; 25:14-30. [PMID: 24593052 DOI: 10.1111/jon.12086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 11/23/2013] [Indexed: 11/29/2022] Open
Abstract
We retrospectively reviewed neuroradiology database at our tertiary-care hospital to search for patients with metaphoric or descriptive signs on brain computed tomography or magnetic resonance imaging. Only patients who had clinical or pathological definitive diagnosis were included in this review.
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Affiliation(s)
- Rahsan Gocmen
- Department of Radiology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey
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Abstract
This article provides an overview of the intra-axial tumors that affect the cerebellum, which can be categorized by location and age. For each tumor, we review conventional neuroimaging findings and discuss the value of more advanced neuroimaging techniques. Current management strategies are also briefly discussed. Finally, cerebellar paraneoplastic disorders and medication-induced cerebellar disorders are discussed.
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Affiliation(s)
- Thomas J Pfiffner
- DENT Neurologic Institute, 3980 Sheridan Drive, Amherst, NY 14226, USA
| | - Ronak Jani
- DENT Neurologic Institute, 3980 Sheridan Drive, Amherst, NY 14226, USA
| | - Laszlo Mechtler
- DENT Neurologic Institute, Roswell Park Cancer Institute, 3980 Sheridan Drive, Buffalo, NY 14226, USA.
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17
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Pinto WBVDR, Souza PVSD. Brain MRI features in Lhermitte-Duclos disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:645. [PMID: 25098484 DOI: 10.1590/0004-282x20140091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/28/2014] [Indexed: 11/22/2022]
Affiliation(s)
| | - Paulo Victor Sgobbi de Souza
- Divisão de Neurologia Geral, Departamento de Neurologia, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil
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WEI GUANGQUAN, ZHANG WEI, LI QINLONG, KANG XIAOWEI, ZHAO HAITAO, LIU XIANPING, TANG XING, WU YUANMING, HAN JUNTAO, YIN HONG. Magnetic resonance characteristics of adult-onset Lhermitte-Duclos disease: An indicator for active cancer surveillance? Mol Clin Oncol 2014; 2:415-420. [PMID: 24772310 PMCID: PMC3999135 DOI: 10.3892/mco.2014.258] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/14/2014] [Indexed: 11/06/2022] Open
Abstract
Lhermitte-Duclos disease (LDD) is a rare, non-cancerous entity characterized by enlarged, abnormally developed cerebellar folia containing dysplastic cells. Symptomatic LDD is commonly observed in adults (adult-onset LDD, aLDD) as an isolated condition or associated with Cowden's disease (CD). The present study aimed to investigate the magnetic resonance imaging (MRI) characteristics and the underlying pathological findings in 7 cases of aLDD, with emphasis on the association with CD and the need for active cancer surveillance once the diagnosis of LDD is confirmed. The MRI findings along with the clinical and histopathological data collected from 7 patients with aLDD were retrospectively reviewed. The diagnosis of CD was based on a range of clinical characteristics, according to the International Cowden Consortium Criteria. A thorough review of the published data was conducted and our results indicated that all 7 cases shared similar MRI characteristics, whether the aLDD was sporadic (2 cases) or associated with CD (5 cases), including a highly typical non-enhancing striated MRI appearance of thickened folia, consisting of alternating bands on T1- and T2-weighted images. On gross examination, the involved cerebellar folia were distorted and enlarged, whereas the histopathological examination revealed that the molecular layer was widened and occupied by abnormal ganglion cells. Moreover, a reduction in the number or absence of the Purkinje cells and hypertrophy of the granular cell layer were observed. Our findings were consistent with the diagnosis of LDD. Variable levels of vacuolization of the white matter and the molecular layer were observed in all the cases. Notably, CD34 immunohistochemical analysis revealed the presence of angiogenesis within the lesions. aLDD associated with CD exhibited no pathological or immunohistochemical characteristics that were distinct from those of isolated aLDD. Of the 7 cases of aLDD, 5 presented with symptoms suggestive of CD, which is a syndrome associated with a high risk of multiple benign and malignant neoplasms. In conclusion, aLDD exhibits characteristic MRI and histopathological findings and displays a strong association with CD. Therefore, we recommend that the MRI diagnosis of aLDD triggers active cancer surveillance and preventive care.
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Affiliation(s)
- GUANGQUAN WEI
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
| | - WEI ZHANG
- Department of Cardiology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710038
| | - QINLONG LI
- Department of Pathology, Xijing Hospital; The Fourth Military Medical University, Xi’an, Shaanxi 710032,
P.R. China
| | - XIAOWEI KANG
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
| | - HAITAO ZHAO
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
| | - XIANPING LIU
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
| | - XING TANG
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
| | - YUANMING WU
- Center for Gene Typing; The Fourth Military Medical University, Xi’an, Shaanxi 710032, P.R.
China
| | - JUNTAO HAN
- Department of Surgery, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032,
P.R. China
| | - HONG YIN
- Molecular Imaging Center, Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710032
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Cohen JE, Gomori M, Benifla M, Itshayek E, Shoshan Y. Acute pseudotumoral hemicerebellitis: Diagnosis and neurosurgical considerations of a rare entity. J Clin Neurosci 2014; 21:337-9. [DOI: 10.1016/j.jocn.2013.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 11/16/2022]
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Nair P, Pal L, Jaiswal AK, Behari S. Lhermitte-Duclos Disease Associated with Dysembryoplastic Neuroepithelial Tumor Differentiation with Characteristic Magnetic Resonance Appearance of “Tiger Striping”. World Neurosurg 2011; 75:699-703. [DOI: 10.1016/j.wneu.2010.10.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 09/01/2010] [Accepted: 10/19/2010] [Indexed: 11/29/2022]
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