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1、 Case report Xian central hospital Dang shan胶质母细胞瘤课件New wordssomnolentia smnlenr 嗜睡 morphology m:rf:ldi 形态学paediatric pi:dtrk 儿科的 hydrocephalushadrsefls 脑积水 heterogeneous 成分混杂的 cauliflower 菜花 neuroepithelial 神经上皮的 prognosis 预后 infiltrate 浸润 渗透 New wordssomnolentia smnleMedical history 2-year-old mal
2、e patient Somnolentia,decrease consciousness 3 hours Medical history胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件胶质母细胞瘤课件 A Ependymoma B Choroid plexus papilloma C Intraventricular meningioma D GlioblastomaWhat is your diagnosis?What is your diagnosis?Pathological result Lateral ventricle
3、 glioblastoma Immunohistochemistry:GFAP +、S-100 +、Vim +、Syn part+、Ki67 40%、Olig-2 few、CD99 -/+、NeuN -CK -、EMA -Pathological resultGlioblastoma Incidence:Glioblastoma accounts for about 57% of all brain tumors in children Peak age:4555 years old less occur at age lower than 30-year-old Location:Supra
4、tentorial white matter most common,especially in frontal and temporal lobes.Glioblastoma Morphology:Poorly-marginated ,diffusely-infiltrating necrotic mass. Tumor typically acrosses white matter tracts to involve contralateral hemispherePrognosis:Poor,1year survival rate is only about 50%胶质母细胞瘤课件NEC
5、T Finding:Irregular isodense or hypodense mass with central hypodensity representing necrosis. Marked mass effect and surrouding edema ,tumor infiltration,hemorrage not uncommon,calcification rareCECT Finding:95%have stong,heterogeneous,irregular rim-enhancementNECT Finding:Irregular isodens T1WI ir
6、regular isotense , hypointense white matter mass T2WI heterogeneous,hypointense mass with adjacent tumor infiltration and edema DWI no typically diffusion restriction necrosis,cysts,hemorrage may be seenMR Finding T1WI irregular isotense , hEpendymoma Peak age:before the age of 5 years oldLocation:
7、about 8% occured in the lateral ventricleMorphology:typically heterogeneous mass ,with areas of necrosis, calcification, cystic change and frequent hemorrhage MR Finding: T1WI isointense to hypointense relative to white matter T2WI hyperintense to white matter T1C+ (Gd) enhancement present but heter
8、ogeneous DWI diffusion restrict may be seen in solid components Ependymoma Peak age:before theCT Ependymoma CT Ependymoma MR Ependymoma MR Ependymoma An uncommon, benign neuroepithelial intraventricular tumour which can occur in both the paediatric and adult .lobulated or cauliflower-like masseshydr
9、ocephalus commonCT iso- or somewhat hyperdense, homogeneous enhancement T1WI typically isointense or somewhat hypointense T2WI iso to hyperintense T1 C+ (Gd) marked enhancement, tends to be homogenous Choroid plexus papilloma An uncommon, benign neuroepithT2WI T1WI T2WI T1WI T1C+ Choroid plexus papi
10、lloma T1C+ Choroid plexus papillomaIntraventricular meningioma Location:80% trigone of lateral ventricle,15% the third ventricle, 5% the fourth ventricle CT 60%slightly hyperdense to normal brain,20- 30% have some calcification,72% brightly and homogenously contrast enhance,less frequent in malignant or cystic variants T1WI isointense or somewhat hypointense compared to grey matter T2WI isointense, hyperintense or hypointense compared to grey matter T1
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