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Jiang H, Qiu L, Song J, Xu D, Sun L, Feng Y, Zhao J, Qian J, Yu Z, Peng J. Clinical progression, pathological characteristics, and radiological findings in children with diffuse leptomeningeal glioneuronal tumors: A systematic review. Front Oncol 2022; 12:970076. [PMID: 36185310 PMCID: PMC9525023 DOI: 10.3389/fonc.2022.970076] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDiffuse leptomeningeal glioneuronal tumors are rare leptomeningeal neoplasms composed of oligodendrocyte-like cells characterized by neuronal differentiation and a lack of isocitrate dehydrogenase gene mutation.PurposeWe aimed to analyze the clinical progression, pathological characteristics, and radiological findings of diffuse leptomeningeal glioneuronal tumors in children, as well as the relevance of clinico-radiological data.Data SourcesWe searched MEDLINE, PubMed, and Web of Science to identify case reports, original articles, and review articles discussing diffuse leptomeningeal glioneuronal tumors published between 2000 and 2021.Study SelectionThe analysis included 145 pediatric patients from 43 previous studies.Data AnalysisData regarding patient pathology, MRI manifestations, clinical symptoms, and progression were collected. The relationship between imaging classification and pathological findings was using chi-square tests. Overall survival was analyzed using Kaplan–Meier curves.Data SynthesisParenchymal tumors were mainly located in the intramedullary areas of the cervical and thoracic spine, and patients which such tumors were prone to 1p-deletion (χ2 = 4.77, p=0.03) and KIAA1549-BRAF fusion (χ2 = 12.17, p<0.001). The median survival time was 173 months, and the survival curve fell significantly before 72 months. Parenchymal tumor location was associated with overall survival (p=0.03), patients with KIAA 1549-BRAF (+) and treated with chemotherapy exhibited a better clinical course (p<0.001).LimitationsThe analysis included case reports rather than consecutively treated patients due to the rarity of diffuse leptomeningeal glioneuronal tumors, which may have introduced a bias.ConclusionsEarly integration of clinical, pathological, and radiological findings is necessary for appropriate management of this tumor, as this may enable early treatment and improve prognosis.
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Affiliation(s)
- Haoxiang Jiang
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Lu Qiu
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Juan Song
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Dandan Xu
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Lei Sun
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Yinbo Feng
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Jun Zhao
- Department of Radiology, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Jun Qian
- Department of Pediatrics, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Zhiwei Yu
- Department of Pediatrics, Wuxi Children’s Hospital Affiliated to Nanjing Medical University, Wuxi, China
- *Correspondence: Zhiwei Yu, ; Jin Peng,
| | - Jin Peng
- Department of Radiology, Xi’an Children’s Hospital, Xi’an, China
- *Correspondence: Zhiwei Yu, ; Jin Peng,
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Chludzinski E, Puff C, Weber J, Hewicker-Trautwein M. Case Report: Primary Diffuse Leptomeningeal Oligodendrogliomatosis in a Young Adult Cat. Front Vet Sci 2021; 8:795126. [PMID: 34977226 PMCID: PMC8714914 DOI: 10.3389/fvets.2021.795126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/22/2021] [Indexed: 11/14/2022] Open
Abstract
A 2-year-old cat was presented with progressive ataxia. Despite treatment the animal died. Pathomorphological examination revealed a widespread leptomeningeal mass at all levels of the central nervous system accentuated on the cervical spinal cord and the medulla oblongata without presence of a primary intraaxial tumor. The neoplasm was mainly composed of round, uninucleate cells with hyperchromatic nuclei, which were immunopositive for OLIG2, doublecortin, MAP2, synaptophysin, and vimentin, indicating components of both oligodendroglial and neuronal differentiation. Ki-67 immunohistochemistry indicated a high proliferation activity of the neoplasm. Few GFAP positive and Iba-1 positive cells were interpreted as reactive astrocytes and macrophages or microglia, respectively. The tumor was immunonegative for CD3, CD20, PAX5, MUM1, pan-cytokeratin, S100, NSE, p75NTR, NeuN and periaxin. These findings led to the diagnosis of primary diffuse leptomeningeal oligodendrogliomatosis. This is the first reported case of this entity in a young cat, which should be considered as a differential diagnosis for diffuse subarachnoidal round cell infiltrates.
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Affiliation(s)
- Elisa Chludzinski
- Department of Pathology, University of Veterinary Medicine, Hannover, Germany
| | - Christina Puff
- Department of Pathology, University of Veterinary Medicine, Hannover, Germany
| | - Jürgen Weber
- Tierärztliche Praxis für Kleintiere Dr. med. vet. Jürgen Weber, Oer-Erkenschwick, Germany
| | - Marion Hewicker-Trautwein
- Department of Pathology, University of Veterinary Medicine, Hannover, Germany
- *Correspondence: Marion Hewicker-Trautwein
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Erdogan K, Mammadkhanli O, Dogan I, Ersoz CC, Okcu AH, Unlu MA. Cranial and Spinal Oligodendrogliomatosis: A Case Report and Review of the Literature. Asian J Neurosurg 2021; 16:626-629. [PMID: 34660384 PMCID: PMC8477819 DOI: 10.4103/ajns.ajns_514_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 11/04/2022] Open
Abstract
Secondary leptomeningeal gliomatosis is a condition known as a result of invasion of the subarachnoid space or the ventricular system of primary intraparenchymal glioma. In this article, we present a 7-year-old boy presented with neck and back deformity and deterioration of gait. Cranial and spinal magnetic resonance imaging revealed lesions in the supratentorial and infratentorial areas, in the brainstem downward the spinal cord. Disseminated oligodendrogliomatosis is extremely rare and our case we present is the 24th in the literature.
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Affiliation(s)
- Koral Erdogan
- Department of Neurosurgery, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey
| | - Orkhan Mammadkhanli
- Department of Neurosurgery, Faculty of Medicine, Yuksek Ihtisas University, Ankara, Turkey
| | - Ihsan Dogan
- Department of Neurosurgery, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey
| | | | - Aylin Heper Okcu
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Agahan Unlu
- Department of Neurosurgery, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey
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Diffuse leptomeningeal glioneuronal tumour (DLGNT) in children: the emerging role of genomic analysis. Acta Neuropathol Commun 2021; 9:147. [PMID: 34493325 PMCID: PMC8422739 DOI: 10.1186/s40478-021-01248-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
Diffuse leptomeningeal glioneuronal tumours (DLGNT) represent rare enigmatic CNS tumours of childhood. Most patients with this disease share common radiological and histopathological features but the clinical course of this disease is variable. A radiological hallmark of this disease is widespread leptomeningeal enhancement that may involve the entire neuroaxis with predilection for the posterior fossa and spine. The classic pathologic features include low- to moderate-density cellular lesions with OLIG2 expression and evidence of ‘oligodendroglioma-like’ appearance. The MAPK/ERK signaling pathway has recently been reported as a potential driver of tumourigenesis in up to 80% of DLGNT with KIAA1549:BRAF fusions being the most common event seen. Until now, limited analysis of the biological drivers of tumourigenesis has been undertaken via targeted profiling, chromosomal analysis and immunohistochemistry. Our study represents the first examples of comprehensive genomic sequencing in DLGNT and shows that it is not only feasible but crucial to our understanding of this rare disease. Moreover, we demonstrate that DLGNT may be more genomically complex than single-event MAPK/ERK signaling pathway tumours.
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Ballester LY, Dunbar E, Guha-Thakurta N, Henson JW, Chandler H, Watkins J, Fuller GN. Primary Leptomeningeal Oligodendroglioma, IDH-Mutant, 1p/19q-Codeleted. Front Neurol 2018; 9:700. [PMID: 30210430 PMCID: PMC6119690 DOI: 10.3389/fneur.2018.00700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/02/2018] [Indexed: 11/13/2022] Open
Abstract
We present a case of a 43-year-old woman with a history of headaches and blurry vision. Ophthalmologic examination identified papilledema. MR imaging demonstrated a right parietal region mass with patchy areas of contrast enhancement and focal calcifications. Intraoperative examination and exploration revealed an extra-axial mass with no apparent parenchymal involvement. Microscopic examination revealed solid sheets of tumor cells with clear cell cytologic features and no discernable intra-parenchymal tumor component. Molecular studies demonstrated the presence of IDH1 IDH1 c.395G>A p.R132H and CIC c.601C>T p.R281W mutations and 1p/19q codeletion. The radiographic features, gross appearance, and microscopic and molecular characteristics of the mass support the diagnosis of primary leptomeningeal oligodendroglioma, IDH-mutant, 1p/19-codeleted. This case represents one of a very few reported instances of molecularly-defined solitary, primary, intracranial oligodendroglioma, without definitive involvement of the brain parenchyma.
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Affiliation(s)
- Leomar Y Ballester
- Department of Pathology and Laboratory Medicine, Houston, TX, United States.,Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Erin Dunbar
- Piedmont Brain Tumor Center, Piedmont Cancer, Atlanta, GA, United States
| | - Nandita Guha-Thakurta
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John W Henson
- Piedmont Brain Tumor Center, Piedmont Cancer, Atlanta, GA, United States
| | - Howard Chandler
- Piedmont Brain Tumor Center, Piedmont Cancer, Atlanta, GA, United States
| | - Jeremiah Watkins
- Piedmont Brain Tumor Center, Piedmont Cancer, Atlanta, GA, United States
| | - Gregory N Fuller
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
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A Case of Diffuse Leptomeningeal Glioneuronal Tumor Misdiagnosed as Chronic Tuberculous Meningitis without Brain Biopsy. Case Rep Neurol Med 2018; 2018:1391943. [PMID: 30112228 PMCID: PMC6077533 DOI: 10.1155/2018/1391943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/27/2018] [Accepted: 06/12/2018] [Indexed: 11/27/2022] Open
Abstract
Here we report a rare case of diffuse leptomeningeal glioneuronal tumor (DLGNT) in a 62-year-old male patient misdiagnosed as having tuberculous meningitis. Due to its rarity and radiologic findings of leptomeningeal enhancement in the basal cisterns on magnetic resonance imaging (MRI) similar to tuberculous meningitis, DLGNT in this patient was initially diagnosed as communicating hydrocephalus from tuberculous meningitis despite absence of laboratory findings of tuberculosis. The patient's symptoms and signs promptly improved after a ventriculoperitoneal shunting surgery followed by empirical treatment against tuberculosis. Five years later, mental confusion and ataxic gait developed in this patient again despite well-functioning ventriculoperitoneal shunt. Aggravation of leptomeningeal enhancement in the basal cisterns was noted in MRI. An additional course of antituberculosis medication with steroid was started without biopsy of the brain. Laboratory examinations for tuberculosis were negative again. After four months of improvement, his mental confusion, memory impairment, dysphasia, and ataxia gradually worsened. A repeated MRI of the brain showed further aggravation of leptomeningeal enhancement in the basal cisterns. Biopsy of the brain surface and leptomeninges revealed a very rare occurrence of DLGNT. His delayed diagnosis of DLGNT might be due to prevalence of tuberculosis in our country, similarity in MRI finding of prominent leptomeningeal enhancement in the basal cisterns, and extreme rarity of DLGNT in the elderly. DLGLT should be considered in differential diagnosis of medical conditions presenting as communicating hydrocephalus with prominent leptomeningeal enhancement. A timely histologic diagnosis through a leptomeningeal biopsy of the brain and spinal cord in case of unusual leptomeningeal enhancement with uncertain laboratory findings is essential because cytologic examination of the cerebrospinal fluid in DLGNT is known to be negative.
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7
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Disseminated Oligodendroglial-like Leptomeningeal Tumor in the Adult: Case Report and Review of the Literature. World Neurosurg 2018. [DOI: 10.1016/j.wneu.2018.02.160] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Diffuse leptomeningeal glioneuronal tumor (DLGNT) mimicking Whipple's disease: a case report and literature review. Childs Nerv Syst 2017; 33:1411-1414. [PMID: 28382437 DOI: 10.1007/s00381-017-3405-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Diffuse leptomeningeal glioneuronal tumor is a new entity under the neuronal and mixed neuronal-glial tumors in the WHO 2016 updated classification and commonly found in children and adolescents. The initial diagnosis is challenging because of its non-specific radiologic feature and negative CSF cytology analysis. A 17 years male was presented with intractable headache subsequently followed by back pain and joint pain. MRI showed enhancement of arachnoid membrane at basal cistern, bilateral sylvian fissure and cerebral cistern with slight enlargement of ventricles. There were no evidences of infection in CSF and blood samples. Based on the duodenal biopsy and prodromal symptom of joint pain, the patient was suspected of having Whipple's disease. Eleven months after the onset, a small mass lesion was observed at the anterior horn of right lateral ventricle. The histology was remarkable for anaplastic oligodendroglioma. Immunostainings revealed positivity for GFAP, Olig2, synaptophysin and negativity for IDH1 mutation, H3K27M. MIB1 labeling index was 40% and 1p19q FISH analysis showed only 1p deletion. Therefore, a final diagnosis of DLGNT was made. CONCLUSION DLGNT should be included as a differential diagnosis of patients with leptomeningeal-enhanced and high CSF protein level with normal white blood cell count.
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Causil LD, Ames R, Puac P, Castillo M. Adult Brain Tumors and Pseudotumors: Interesting (Bizarre) Cases. Neuroimaging Clin N Am 2017; 26:667-689. [PMID: 27712799 DOI: 10.1016/j.nic.2016.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Some brain tumors results are interesting due to their rarity at presentation and overwhelming imaging characteristics, posing a diagnostic challenge in the eyes of any experienced neuroradiologist. This article focuses on the most important features regarding epidemiology, location, clinical presentation, histopathology, and imaging findings of cases considered "bizarre." A review of the most recent literature dealing with these unusual tumors and pseudotumors is presented, highlighting key points related to the diagnosis, treatments, outcomes, and differential diagnosis.
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Affiliation(s)
- Lazaro D Causil
- Neuroradiology Section, Department of Radiology, University of North Carolina School of Medicine, Room 3326, Old Infirmary Building, Manning Drive, Chapel Hill, NC 27599-7510, USA.
| | - Romy Ames
- Neuroradiology Section, Department of Radiology, University of North Carolina School of Medicine, Room 3326, Old Infirmary Building, Manning Drive, Chapel Hill, NC 27599-7510, USA
| | - Paulo Puac
- Neuroradiology Section, Department of Radiology, University of North Carolina School of Medicine, Room 3326, Old Infirmary Building, Manning Drive, Chapel Hill, NC 27599-7510, USA
| | - Mauricio Castillo
- Department of Radiology, University of North Carolina School of Medicine, Room 3326, Old Infirmary Building, Manning Drive, Chapel Hill, NC 27599-7510, USA
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Chellathurai A, Vaidya JS, Kathirvelu G, Alagappan P. Primary diffuse leptomeningeal oligodendrogliomatosis: A case report and literature review. Indian J Radiol Imaging 2016; 26:337-341. [PMID: 27857459 PMCID: PMC5036331 DOI: 10.4103/0971-3026.190424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Primary leptomeningeal oligodendrogliomatosis (PLO) is a rare low-grade intracranial and spinal canal subarachnoid neoplasm without an obvious primary neoplasm in the brain or spinal cord parenchyma. We present here the serial progression of radiological findings of this rare disease in a 2-year-old male child whose clinical status deteriorated over a period of 4 months with the main complaint of partial seizures. During this period, the MR findings progressed from mild hydrocephalus with minimal leptomeningeal enhancement to leptomeningeal multiple cystic lesions in the entire neuraxis including the spine.
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Affiliation(s)
- Amarnath Chellathurai
- Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
| | - Jay S Vaidya
- Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
| | | | - Periakaruppan Alagappan
- Department of Radiodiagnosis, Tamil Nadu Multispeciality Hospital, Omandurar, Chennai, Tamil Nadu, India
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Dodgshun AJ, SantaCruz N, Hwang J, Ramkissoon SH, Malkin H, Bergthold G, Manley P, Chi S, MacGregor D, Goumnerova L, Sullivan M, Ligon K, Beroukhim R, Herrington B, Kieran MW, Hansford JR, Bandopadhayay P. Disseminated glioneuronal tumors occurring in childhood: treatment outcomes and BRAF alterations including V600E mutation. J Neurooncol 2016; 128:293-302. [PMID: 26994902 DOI: 10.1007/s11060-016-2109-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 03/10/2016] [Indexed: 12/21/2022]
Abstract
Disseminated glioneuronal tumors of childhood are rare. We present a retrospective IRB-approved review of the clinical course and frequency of BRAF mutations in disseminated glioneuronal tumors at two institutions. Defining features of our cohort include diffuse leptomeningeal-spread, often with a discrete spinal cord nodule and oligodendroglioma-like histologic features. Patients were identified through a pathology database search of all cases with disseminated low-grade neoplasms with an oligodendroglioma-like component. De-identified clinical information was collected by chart review and all imaging was reviewed. We retrieved the results of targeted genomic analyses for alterations in BRAF. Ten patients (aged 2-14 years) were identified from the Dana-Farber/Boston Children's Hospital and the Royal Children's Hospital, Melbourne pathology databases. Nine patients received chemotherapy. Eight patients are alive, although three have had episodes of progressive disease. We identified genomic alterations affecting the MAPK pathway in six patients. One patient had a germline RAF1 mutation and a clinical diagnosis of cardio-facio-cutaneous syndrome. BRAF duplications were identified in four and BRAF V600E mutation was identified in one. These data support the presence of targetable genomic alterations in this disease.
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Affiliation(s)
- Andrew J Dodgshun
- Children's Cancer Centre, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, 3052, Australia.
| | - Nadine SantaCruz
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Jaeho Hwang
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Shakti H Ramkissoon
- Department of Medical Oncology, Dana-Faber Cancer Institute, Boston, 02115, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Hayley Malkin
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Guillaume Bergthold
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Peter Manley
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Susan Chi
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Duncan MacGregor
- Department of Pathology, Royal Children's Hospital, Melbourne, VIC, 3052, Australia
| | - Liliana Goumnerova
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Boston Children's Hospital, Boston, MA, USA
- Department of Neurosurgery, Harvard Medical School, Boston, MA, USA
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
| | - Keith Ligon
- Department of Medical Oncology, Dana-Faber Cancer Institute, Boston, 02115, USA
- Broad Institute of MIT and Harvard, Cambridge, USA
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Rameen Beroukhim
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Faber Cancer Institute, Boston, 02115, USA
- Broad Institute of MIT and Harvard, Cambridge, USA
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Betty Herrington
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mark W Kieran
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA
- Harvard Medical School, Boston, MA, USA
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
| | - Pratiti Bandopadhayay
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, 450 Longwood Ave, Boston, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
- Broad Institute of MIT and Harvard, Cambridge, USA.
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
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Rossi S, Rodriguez F, Dei Tos A, Di Paola F, Bendini M, Jenkins R, Giannini C. Re: Diffuse leptomeningeal glioneuronal tumors: a new entity? Brain Pathol 2009; 19:745; author reply 746. [PMID: 19744049 DOI: 10.1111/j.1750-3639.2009.00330.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gardiman MP, Fassan M, Orvieto E, D'Avella D, Denaro L, Calderone M, Severino M, Scarsello G, Viscardi E, Perilongo G. Diffuse leptomeningeal glioneuronal tumors: a new entity? Brain Pathol 2009; 20:361-6. [PMID: 19486008 DOI: 10.1111/j.1750-3639.2009.00285.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The peculiar radiological and pathological findings of four pediatric cases admitted to the University Hospital of Padua between 1990 and 2007 are described. In all cases, the contrast-enhanced head and spine magnetic resonance images revealed thickened and abnormally enhancing subarachnoid spaces particularly at the level of basal cisterns and interhemispheric fissure. Furthermore, small cystic lesions scattered throughout the brain and mainly in the cerebellum were also visible. All patients were missing a well-defined intraparenchymal mass, although during the follow-up a small intramedullary lesion appeared within the cervical spine in two and subsequently in the frontal horn of the left lateral ventricle in one of those. All patients presented an indolent long-term follow-up. Histologically, the tumors were composed by a monotonous population of cells arranged in straight lines or in small lobules. The cells were characterized by round to oval nuclei with finely granular dispersed chromatin, inconspicuous nucleoli with oligodendrocyte-like features. The morphological and immunohistochemical findings suggested in all cases a "glioneuronal commitment" of the tumors. Because of the unique similar clinical and neuroradiological characteristics, we propose this small series of tumors as a new possible distinct pathological and clinical entity.
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Affiliation(s)
- Marina Paola Gardiman
- Department of Oncological and Surgical Sciences, Division of Pathology, University Hospital of Padua, Padua, Italy.
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Mathews MS, Paré LS, Kuo JV, Kim RC. Primary leptomeningeal oligodendrogliomatosis. J Neurooncol 2009; 94:275-8. [PMID: 19290482 PMCID: PMC2724631 DOI: 10.1007/s11060-009-9821-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 02/23/2009] [Indexed: 11/13/2022]
Abstract
Primary leptomeningeal oligodendrogliomas (PLOs) are rare intracranial malignancies where tumors grow in the subarachnoid space without an obvious connection to the brain or spinal cord parenchyma. Adding to the three previously reported cases of PLO with no parenchymal involvement we report a fourth case of the same in this paper in a 50-year-old woman presenting with unrelenting headaches. CT scan of her head revealed hydrocephalus and MRI revealed diffuse enhancement of her leptomeninges throughout her brain and spine, prominent over the basilar region. Biopsy obtained using a frameless stereotactic biopsy showed sharply defined cell borders, clear cytoplasm, and rounded nuclei consistent with an oligodendroglioma. Our case suggests that PLO can mimic diffuse forms of granulomatous meningitis and should be suspected in patients that clinically and radiographically present like granulomatous meningitis but without blood or CSF markers for the same.
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Affiliation(s)
- Marlon S Mathews
- Department of Neurological Surgery, State University New York at Buffalo, Buffalo, USA.
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