This document provides an overview of the WHO classification of non-neuroepithelial brain tumors. It discusses several tumor types including meningiomas, germ cell tumors, hematopoietic tumors, and others. For each tumor type, it describes common locations, imaging findings on CT and MRI, including enhancement patterns and other imaging characteristics. Key tumors discussed in detail include meningioma, germinoma, embryonal carcinoma, and hemangioblastoma.
The document provides an overview of mediastinal tumors and lesions. It discusses inflammatory diseases like acute and chronic mediastinitis. It also covers cysts, thymic lesions including thymoma, lymphomas, neurogenic tumors, and metastatic tumors. Specific conditions are described such as fibrosing mediastinitis, thymic cysts, and different non-neoplastic thymic diseases. The anatomy of the mediastinum and different tumor types are outlined in detail.
1. The document discusses the approach to evaluating and diagnosing mediastinal masses, with a focus on distinguishing masses by their location in the anterior, middle, or posterior mediastinum.
2. Common diseases found in each compartment are reviewed, along with their typical presentations and investigations such as biopsy methods.
3. Surgical and non-surgical treatment options are presented for various mediastinal pathologies like thymoma, teratomas, and lymphomas.
Primary CNS lymphoma most commonly presents as enhancing lesions in the supratentorial white matter and deep gray nuclei. On imaging, it appears hyperdense on non-contrast CT and shows strong homogeneous enhancement on contrast-enhanced CT and MRI in immunocompetent patients. In immunocompromised patients, it may enhance peripherally with central necrosis. Restricted diffusion is also seen. Medulloblastoma appears as a hyperdense mass in the fourth ventricle, commonly with hydrocephalus. It enhances strongly and heterogeneously on contrast. Germinoma presents as a lobulated pineal or suprasellar mass that engulfs or drapes around the pineal gland. It shows avid homogeneous enhancement with
This document discusses mediastinal pathology using a compartmental approach. It describes the anatomy of the mediastinum and divides it into anterior, middle, and posterior compartments. Each compartment contains different structures and has a characteristic distribution of lesions. For example, 50% of lesions occur in the anterior compartment, which contains the thymus. The thymus is the most common site of lesions in the anterior compartment. Thymomas are the most common epithelial tumors of the thymus and mediastinum.
Mediastinal masses can cause compression of mediastinal structures and symptoms known as mediastinal syndrome. 33% of masses occur in patients under 15 years old. Small masses may be asymptomatic while large masses usually cause respiratory distress. The document discusses the anatomy and contents of the mediastinum and various masses that can occur in the anterior, middle, and posterior compartments including thymoma, teratoma, lymphoma, germ cell tumors, neurogenic tumors, and others. Clinical presentation depends on the size and location of the mass and can include symptoms of tracheal, esophageal, or vascular compression. Diagnostic evaluation involves imaging like CT and biopsy when needed.
This document discusses imaging and characterization of anterior and middle mediastinal masses. It begins by outlining objectives of presenting an updated mediastinal compartment classification based on CT landmarks, showing signs to characterize masses on CT/MR, and describing common masses. It then discusses localization of masses using the center method and structure displacement tool. Key points covered include appearance and examples of fat-containing lesions, cysts/cystic lesions, vascular masses, soft tissue masses in the anterior mediastinum, and lymphomas. Common anterior mediastinal masses like thymoma and teratomas are described in detail.
This document outlines an approach to evaluating mediastinal pathology using radiological imaging. It begins with definitions of the mediastinum and schemes for dividing it anatomically. It then describes how to approach lesions based on their location in the anterior, middle, or posterior mediastinum. Common pathologies are discussed for each division, including lymphadenopathy, thymomas, cysts, and vascular lesions. Radiological investigations like chest x-rays, CT, MRI, and biopsies are outlined. Specific conditions such as retrosternal goiters, germ cell tumors, lipomatosis, and hernias are also summarized.
The document discusses various pediatric retroperitoneal masses. It begins by noting that abdominal masses are most common in children under 5 years old and retroperitoneal masses in neonates are often kidney-related and benign. It then characterizes the retroperitoneal space and lists common retroperitoneal organs. Several pathologies are discussed in detail, including neuroblastoma, Wilms tumor, nephroblastomatosis, and renal cell carcinoma. Imaging findings for many conditions are provided. The document serves as an overview of pediatric retroperitoneal masses and their imaging appearances.
The document provides an overview of mediastinal tumors and lesions. It discusses inflammatory diseases like acute and chronic mediastinitis. It also covers cysts, thymic lesions including thymoma, lymphomas, neurogenic tumors, and metastatic tumors. Specific conditions are described such as fibrosing mediastinitis, thymic cysts, and different non-neoplastic thymic diseases. The anatomy of the mediastinum and different tumor types are outlined in detail.
1. The document discusses the approach to evaluating and diagnosing mediastinal masses, with a focus on distinguishing masses by their location in the anterior, middle, or posterior mediastinum.
2. Common diseases found in each compartment are reviewed, along with their typical presentations and investigations such as biopsy methods.
3. Surgical and non-surgical treatment options are presented for various mediastinal pathologies like thymoma, teratomas, and lymphomas.
Primary CNS lymphoma most commonly presents as enhancing lesions in the supratentorial white matter and deep gray nuclei. On imaging, it appears hyperdense on non-contrast CT and shows strong homogeneous enhancement on contrast-enhanced CT and MRI in immunocompetent patients. In immunocompromised patients, it may enhance peripherally with central necrosis. Restricted diffusion is also seen. Medulloblastoma appears as a hyperdense mass in the fourth ventricle, commonly with hydrocephalus. It enhances strongly and heterogeneously on contrast. Germinoma presents as a lobulated pineal or suprasellar mass that engulfs or drapes around the pineal gland. It shows avid homogeneous enhancement with
This document discusses mediastinal pathology using a compartmental approach. It describes the anatomy of the mediastinum and divides it into anterior, middle, and posterior compartments. Each compartment contains different structures and has a characteristic distribution of lesions. For example, 50% of lesions occur in the anterior compartment, which contains the thymus. The thymus is the most common site of lesions in the anterior compartment. Thymomas are the most common epithelial tumors of the thymus and mediastinum.
Mediastinal masses can cause compression of mediastinal structures and symptoms known as mediastinal syndrome. 33% of masses occur in patients under 15 years old. Small masses may be asymptomatic while large masses usually cause respiratory distress. The document discusses the anatomy and contents of the mediastinum and various masses that can occur in the anterior, middle, and posterior compartments including thymoma, teratoma, lymphoma, germ cell tumors, neurogenic tumors, and others. Clinical presentation depends on the size and location of the mass and can include symptoms of tracheal, esophageal, or vascular compression. Diagnostic evaluation involves imaging like CT and biopsy when needed.
This document discusses imaging and characterization of anterior and middle mediastinal masses. It begins by outlining objectives of presenting an updated mediastinal compartment classification based on CT landmarks, showing signs to characterize masses on CT/MR, and describing common masses. It then discusses localization of masses using the center method and structure displacement tool. Key points covered include appearance and examples of fat-containing lesions, cysts/cystic lesions, vascular masses, soft tissue masses in the anterior mediastinum, and lymphomas. Common anterior mediastinal masses like thymoma and teratomas are described in detail.
This document outlines an approach to evaluating mediastinal pathology using radiological imaging. It begins with definitions of the mediastinum and schemes for dividing it anatomically. It then describes how to approach lesions based on their location in the anterior, middle, or posterior mediastinum. Common pathologies are discussed for each division, including lymphadenopathy, thymomas, cysts, and vascular lesions. Radiological investigations like chest x-rays, CT, MRI, and biopsies are outlined. Specific conditions such as retrosternal goiters, germ cell tumors, lipomatosis, and hernias are also summarized.
The document discusses various pediatric retroperitoneal masses. It begins by noting that abdominal masses are most common in children under 5 years old and retroperitoneal masses in neonates are often kidney-related and benign. It then characterizes the retroperitoneal space and lists common retroperitoneal organs. Several pathologies are discussed in detail, including neuroblastoma, Wilms tumor, nephroblastomatosis, and renal cell carcinoma. Imaging findings for many conditions are provided. The document serves as an overview of pediatric retroperitoneal masses and their imaging appearances.
This document discusses the diagnostic workup for mediastinal tumors. It begins by describing the different types of tumors that can occur in the anterior, middle, and posterior mediastinum. Signs and symptoms are non-specific but may include cough, chest pain, and weight loss. Chest x-ray is often the initial test, while CT scan provides more detail on location and tissue characteristics. MRI and nuclear imaging can further characterize masses. Tissue sampling methods include needle biopsy, mediastinoscopy, and thoracoscopy. Surgical procedures like mediastinotomy or thoracotomy may be needed in some cases. Laboratory tests help identify certain tumor types. A multidisciplinary approach is typically needed for diagnosis and treatment planning of
Posterior Mediastinal Lesions : A Short ReviewAlireza Kashani
This document discusses posterior mediastinal lesions. It begins by defining the posterior mediastinum and noting that it most commonly contains neurogenic tumors in children and lymphomas or thymomas in adults. Neurogenic tumors are further discussed, including that they originate from neural crest cells and can be benign such as neurofibromas or malignant like neurosarcomas. Specific neurogenic tumors from intercostal nerves or the sympathetic ganglia are described. The document provides details on diagnostic imaging and biopsy of posterior mediastinal lesions and summarizes management approaches.
The document discusses pathology of mediastinal tumors. It begins with anatomy of the mediastinum and its compartments. Common tumor types in each compartment are then described, including thymomas, thymic carcinomas, germ cell tumors, neurogenic tumors, and lymphomas. Key features of thymomas such as classification, staging, and treatment approaches are summarized in depth. The document provides an overview of mediastinal tumor pathology.
Mediastinal masses can occur in the anterior, middle, or posterior mediastinum. Common anterior mediastinal masses include thymoma, Hodgkin's lymphoma, and thyroid tumors. Middle mediastinal masses may include bronchogenic cysts or enlarged thyroid tumors. Posterior mediastinal masses are often neurogenic tumors, esophageal tumors, or hiatal hernias. Imaging with CT scan and biopsy are used to identify mass characteristics and guide management, which could include surgical excision or biopsy depending on the suspected malignancy risk. Complications of mediastinal mass surgery include increased risks of morbidity due to potential airway obstruction.
The document provides an update on thymomas. It discusses the history of classifications of thymic epithelial tumors in WHO editions. There are conceptual continuity and changes in the new WHO classification, including refined diagnostic criteria for thymoma subtypes and proposal of a new TNM staging system. Key discoveries include recurrent mutations in the GTF2I oncogene in thymomas and thymic carcinomas, and distinct molecular bases between the two entities. Comprehensive genomic analysis has shown thymic carcinomas are molecularly different from thymomas.
The document discusses mediastinal tumors, which are masses or growths located in the mediastinum, the area within the chest between the lungs. It describes the different types of tumors that can occur in the various sections of the mediastinum and their causes. It also outlines some common symptoms, diagnostic tests, treatment options, and prognosis for different mediastinal tumors.
This document discusses angiomyolipomas (AML), a type of benign renal tumor composed of blood vessels, smooth muscle, and fat cells. It describes the typical presentation of isolated and tuberous sclerosis-associated AML, including that isolated AML most often present as solitary lesions in the right kidney in women, while AML associated with tuberous sclerosis are typically bilateral and occur equally in men and women. Imaging findings are also summarized, noting the characteristic fat content visible on CT and MRI that appears echogenic on ultrasound and enhances heterogeneously after contrast. Angiography further demonstrates the hypervascular and tortuous nature of AML vasculature.
Retroperitoneal fibrosis is characterized by proliferation of fibroinflammatory tissue that surrounds the abdominal aorta and iliac vessels. This process frequently entraps and obstructs the ureters, leading to renal failure. The idiopathic form accounts for over two-thirds of cases. Symptoms are often nonspecific initially but progress to include obstructive uropathy and renal impairment. Diagnosis relies on imaging findings of a soft tissue mass encasing the aorta and ureters on CT or MRI. Differentiating benign from malignant retroperitoneal fibrosis is important, as the prognosis differs significantly.
This document discusses superior mediastinal syndrome, which involves obstruction of the airways or blood vessels in the mediastinum from a mass. Common causes include lymphoma and germ cell tumors. Symptoms include difficulty breathing, coughing, chest pain, and swelling of the face and upper body due to obstruction of the superior vena cava. Left untreated, superior mediastinal syndrome can lead to a medical emergency from loss of cardiac output or increased intracranial pressure.
The document provides information on tumors and masses located in the mediastinum. It begins with an overview of the anatomy of the mediastinum and then describes the various pathologies that can occur in each compartment, including the most common tumor types seen in children and adults. For some of the major tumor types such as thymomas, neurogenic tumors, and germ cell tumors, it provides details on characteristics, clinical presentation, diagnostic evaluation, and treatment approaches. The document emphasizes that surgical resection is the main treatment for most mediastinal masses but chemotherapy and/or radiation are also used as adjuvant therapies for malignant tumors.
Chest wall tumours can be divided into benign or malignant tumours of soft tissue or bone. Common benign soft tissue tumours include haemangioma and lymphangioma, while fibrous dysplasia and aneurysmal bone cyst are benign bone tumours. Primary malignant lesions are often metastases. Primary chest wall cancers include chondrosarcoma, osteosarcoma, and Ewing's sarcoma. Surgical resection is the main treatment, with reconstruction of large defects using mesh or flaps.
1. Adrenal imaging uses modalities like ultrasound, CT, MRI, and nuclear medicine to evaluate the adrenal glands and detect abnormalities.
2. CT is often the first choice to evaluate adrenal diseases and can characterize adrenal masses using attenuation values, enhancement patterns, and lipid content analysis.
3. Benign adrenal lesions include adenomas, myelolipomas, cysts, infections, and hemorrhages. Adenomas are the most common and often appear well-defined and homogeneous with characteristic lipid content and enhancement patterns on CT and MRI.
1) Hepatic hemangiomas are benign liver tumors consisting of blood-filled cavities lined by endothelial cells.
2) They are usually asymptomatic but can sometimes cause pain, nausea, or other digestive symptoms. Complications include bleeding, infection, or mass effect.
3) Diagnosis is usually made using ultrasound, CT, or MRI which show characteristic patterns of enhancement. Treatment is usually conservative but resection may be considered for large or symptomatic hemangiomas.
Retroperitoneal fibrosis is a rare condition where a fibro-inflammatory mass envelops and potentially obstructs retroperitoneal structures like the ureters. It is idiopathic in most cases. Imaging shows a soft tissue mass surrounding the aorta and ureters, often causing hydronephrosis. Treatment involves stenting of the ureters to relieve obstruction and use of corticosteroids or immunosuppressants to reduce inflammation and fibrosis in active cases. Biopsy is needed to confirm diagnosis and rule out malignancy. The goal of management is to preserve renal function and prevent involvement of other organs.
This document provides information about acute colonic diverticulitis (ACD) including:
- ACD is a complication of colonic diverticulosis where diverticula in the colon become inflamed or infected.
- CT scan is the preferred imaging method to diagnose and stage ACD. Findings on CT scan include colon wall thickening, pericolic stranding, and abscess formation in severe cases.
- ACD is classified as uncomplicated or complicated, with complicated ACD further divided into stages depending on the extent of inflammation and abscess formation. Potential complications of ACD include abscess, fistula formation, and perforation.
This document discusses mediastinal tumors, including their anatomy, types, clinical presentation, diagnosis, and treatment. The mediastinum contains vital structures like the heart, lungs and blood vessels. Tumors can arise primarily in the mediastinum or spread there from other areas. Common primary tumors include thymomas, lymphomas, and neurogenic tumors. Thymomas are often associated with myasthenia gravis and can be staged using the Masaoka system. Diagnosis involves imaging tests and biopsy. Treatment depends on the tumor type but may include surgery, radiation, chemotherapy or targeted therapy. Care before and after surgery aims to optimize the patient's condition and recovery.
This document summarizes renal cell carcinoma (RCC). It originates in the renal cortex and arises mostly from the upper pole, accounting for 80-85% of primary renal tumors. RCC is classified based on morphology and genetics. Risk factors include smoking, obesity, and genetic syndromes. Symptoms include hematuria but often presents without symptoms. Diagnosis involves imaging like CT or MRI. Treatment of localized RCC is typically radical nephrectomy. For advanced or metastatic RCC, options include immunotherapy, targeted therapy, and radiation.
The document discusses imaging modalities for evaluating the thyroid gland including ultrasound, CT, MRI, nuclear scintigraphy, and PET. It covers anatomy, embryology, and the role of various imaging techniques in assessing congenital abnormalities, nodular diseases, diffuse diseases, and thyroid malignancies. Imaging findings for common pathologies like papillary carcinoma, Hashimoto's thyroiditis, and Graves' disease are also summarized.
The document discusses mediastinal tumors and their diagnosis. It notes that the distribution of mediastinal masses differs between children and adults, with posterior masses more common in children and anterior masses in adults. Imaging tools like chest X-ray, CT scan, and MRI are used to identify and characterize mediastinal lesions. CT scan is the preferred method to examine the middle mediastinum. Biological markers can provide information about certain tumor types like germ cell tumors. The likelihood of malignancy depends on factors like location, patient age, and symptoms.
This document discusses pediatric abdominal tumors and provides information on evaluating and characterizing various tumors through imaging modalities like ultrasound, CT, and MRI. Key tumors mentioned include Wilm's tumor of the kidney, cystic nephroma, clear cell sarcoma, rhabdoid tumor, neuroblastoma, hepatoblastoma, hepatocellular carcinoma, lymphoma, leukemia, and rhabdomyosarcoma. Imaging findings for different tumors are outlined to help determine the tumor type and guide diagnosis and treatment.
The document discusses central nervous system (CNS) tumors. It provides information on different types of primary and secondary brain tumors seen in adults and children, including meningiomas, gliomas such as astrocytomas and glioblastomas, medulloblastomas, and nerve sheath tumors. Key points covered include the typical locations, presentations, pathological features, and distinguishing characteristics of common CNS tumors.
This document provides information on intracranial space occupying lesions including classification, types of brain tumors, clinical manifestations, diagnostic measures, treatment options including surgery, radiation and chemotherapy, as well as postoperative complications. It classifies lesions as congenital, traumatic, inflammatory, parasitic or neoplastic and describes common tumor types such as gliomas, meningiomas and pituitary adenomas. Diagnostic tools include CT, MRI, PET and biopsy. Treatment involves surgery, radiation including gamma knife and brachytherapy, as well as chemotherapy.
This document discusses the diagnostic workup for mediastinal tumors. It begins by describing the different types of tumors that can occur in the anterior, middle, and posterior mediastinum. Signs and symptoms are non-specific but may include cough, chest pain, and weight loss. Chest x-ray is often the initial test, while CT scan provides more detail on location and tissue characteristics. MRI and nuclear imaging can further characterize masses. Tissue sampling methods include needle biopsy, mediastinoscopy, and thoracoscopy. Surgical procedures like mediastinotomy or thoracotomy may be needed in some cases. Laboratory tests help identify certain tumor types. A multidisciplinary approach is typically needed for diagnosis and treatment planning of
Posterior Mediastinal Lesions : A Short ReviewAlireza Kashani
This document discusses posterior mediastinal lesions. It begins by defining the posterior mediastinum and noting that it most commonly contains neurogenic tumors in children and lymphomas or thymomas in adults. Neurogenic tumors are further discussed, including that they originate from neural crest cells and can be benign such as neurofibromas or malignant like neurosarcomas. Specific neurogenic tumors from intercostal nerves or the sympathetic ganglia are described. The document provides details on diagnostic imaging and biopsy of posterior mediastinal lesions and summarizes management approaches.
The document discusses pathology of mediastinal tumors. It begins with anatomy of the mediastinum and its compartments. Common tumor types in each compartment are then described, including thymomas, thymic carcinomas, germ cell tumors, neurogenic tumors, and lymphomas. Key features of thymomas such as classification, staging, and treatment approaches are summarized in depth. The document provides an overview of mediastinal tumor pathology.
Mediastinal masses can occur in the anterior, middle, or posterior mediastinum. Common anterior mediastinal masses include thymoma, Hodgkin's lymphoma, and thyroid tumors. Middle mediastinal masses may include bronchogenic cysts or enlarged thyroid tumors. Posterior mediastinal masses are often neurogenic tumors, esophageal tumors, or hiatal hernias. Imaging with CT scan and biopsy are used to identify mass characteristics and guide management, which could include surgical excision or biopsy depending on the suspected malignancy risk. Complications of mediastinal mass surgery include increased risks of morbidity due to potential airway obstruction.
The document provides an update on thymomas. It discusses the history of classifications of thymic epithelial tumors in WHO editions. There are conceptual continuity and changes in the new WHO classification, including refined diagnostic criteria for thymoma subtypes and proposal of a new TNM staging system. Key discoveries include recurrent mutations in the GTF2I oncogene in thymomas and thymic carcinomas, and distinct molecular bases between the two entities. Comprehensive genomic analysis has shown thymic carcinomas are molecularly different from thymomas.
The document discusses mediastinal tumors, which are masses or growths located in the mediastinum, the area within the chest between the lungs. It describes the different types of tumors that can occur in the various sections of the mediastinum and their causes. It also outlines some common symptoms, diagnostic tests, treatment options, and prognosis for different mediastinal tumors.
This document discusses angiomyolipomas (AML), a type of benign renal tumor composed of blood vessels, smooth muscle, and fat cells. It describes the typical presentation of isolated and tuberous sclerosis-associated AML, including that isolated AML most often present as solitary lesions in the right kidney in women, while AML associated with tuberous sclerosis are typically bilateral and occur equally in men and women. Imaging findings are also summarized, noting the characteristic fat content visible on CT and MRI that appears echogenic on ultrasound and enhances heterogeneously after contrast. Angiography further demonstrates the hypervascular and tortuous nature of AML vasculature.
Retroperitoneal fibrosis is characterized by proliferation of fibroinflammatory tissue that surrounds the abdominal aorta and iliac vessels. This process frequently entraps and obstructs the ureters, leading to renal failure. The idiopathic form accounts for over two-thirds of cases. Symptoms are often nonspecific initially but progress to include obstructive uropathy and renal impairment. Diagnosis relies on imaging findings of a soft tissue mass encasing the aorta and ureters on CT or MRI. Differentiating benign from malignant retroperitoneal fibrosis is important, as the prognosis differs significantly.
This document discusses superior mediastinal syndrome, which involves obstruction of the airways or blood vessels in the mediastinum from a mass. Common causes include lymphoma and germ cell tumors. Symptoms include difficulty breathing, coughing, chest pain, and swelling of the face and upper body due to obstruction of the superior vena cava. Left untreated, superior mediastinal syndrome can lead to a medical emergency from loss of cardiac output or increased intracranial pressure.
The document provides information on tumors and masses located in the mediastinum. It begins with an overview of the anatomy of the mediastinum and then describes the various pathologies that can occur in each compartment, including the most common tumor types seen in children and adults. For some of the major tumor types such as thymomas, neurogenic tumors, and germ cell tumors, it provides details on characteristics, clinical presentation, diagnostic evaluation, and treatment approaches. The document emphasizes that surgical resection is the main treatment for most mediastinal masses but chemotherapy and/or radiation are also used as adjuvant therapies for malignant tumors.
Chest wall tumours can be divided into benign or malignant tumours of soft tissue or bone. Common benign soft tissue tumours include haemangioma and lymphangioma, while fibrous dysplasia and aneurysmal bone cyst are benign bone tumours. Primary malignant lesions are often metastases. Primary chest wall cancers include chondrosarcoma, osteosarcoma, and Ewing's sarcoma. Surgical resection is the main treatment, with reconstruction of large defects using mesh or flaps.
1. Adrenal imaging uses modalities like ultrasound, CT, MRI, and nuclear medicine to evaluate the adrenal glands and detect abnormalities.
2. CT is often the first choice to evaluate adrenal diseases and can characterize adrenal masses using attenuation values, enhancement patterns, and lipid content analysis.
3. Benign adrenal lesions include adenomas, myelolipomas, cysts, infections, and hemorrhages. Adenomas are the most common and often appear well-defined and homogeneous with characteristic lipid content and enhancement patterns on CT and MRI.
1) Hepatic hemangiomas are benign liver tumors consisting of blood-filled cavities lined by endothelial cells.
2) They are usually asymptomatic but can sometimes cause pain, nausea, or other digestive symptoms. Complications include bleeding, infection, or mass effect.
3) Diagnosis is usually made using ultrasound, CT, or MRI which show characteristic patterns of enhancement. Treatment is usually conservative but resection may be considered for large or symptomatic hemangiomas.
Retroperitoneal fibrosis is a rare condition where a fibro-inflammatory mass envelops and potentially obstructs retroperitoneal structures like the ureters. It is idiopathic in most cases. Imaging shows a soft tissue mass surrounding the aorta and ureters, often causing hydronephrosis. Treatment involves stenting of the ureters to relieve obstruction and use of corticosteroids or immunosuppressants to reduce inflammation and fibrosis in active cases. Biopsy is needed to confirm diagnosis and rule out malignancy. The goal of management is to preserve renal function and prevent involvement of other organs.
This document provides information about acute colonic diverticulitis (ACD) including:
- ACD is a complication of colonic diverticulosis where diverticula in the colon become inflamed or infected.
- CT scan is the preferred imaging method to diagnose and stage ACD. Findings on CT scan include colon wall thickening, pericolic stranding, and abscess formation in severe cases.
- ACD is classified as uncomplicated or complicated, with complicated ACD further divided into stages depending on the extent of inflammation and abscess formation. Potential complications of ACD include abscess, fistula formation, and perforation.
This document discusses mediastinal tumors, including their anatomy, types, clinical presentation, diagnosis, and treatment. The mediastinum contains vital structures like the heart, lungs and blood vessels. Tumors can arise primarily in the mediastinum or spread there from other areas. Common primary tumors include thymomas, lymphomas, and neurogenic tumors. Thymomas are often associated with myasthenia gravis and can be staged using the Masaoka system. Diagnosis involves imaging tests and biopsy. Treatment depends on the tumor type but may include surgery, radiation, chemotherapy or targeted therapy. Care before and after surgery aims to optimize the patient's condition and recovery.
This document summarizes renal cell carcinoma (RCC). It originates in the renal cortex and arises mostly from the upper pole, accounting for 80-85% of primary renal tumors. RCC is classified based on morphology and genetics. Risk factors include smoking, obesity, and genetic syndromes. Symptoms include hematuria but often presents without symptoms. Diagnosis involves imaging like CT or MRI. Treatment of localized RCC is typically radical nephrectomy. For advanced or metastatic RCC, options include immunotherapy, targeted therapy, and radiation.
The document discusses imaging modalities for evaluating the thyroid gland including ultrasound, CT, MRI, nuclear scintigraphy, and PET. It covers anatomy, embryology, and the role of various imaging techniques in assessing congenital abnormalities, nodular diseases, diffuse diseases, and thyroid malignancies. Imaging findings for common pathologies like papillary carcinoma, Hashimoto's thyroiditis, and Graves' disease are also summarized.
The document discusses mediastinal tumors and their diagnosis. It notes that the distribution of mediastinal masses differs between children and adults, with posterior masses more common in children and anterior masses in adults. Imaging tools like chest X-ray, CT scan, and MRI are used to identify and characterize mediastinal lesions. CT scan is the preferred method to examine the middle mediastinum. Biological markers can provide information about certain tumor types like germ cell tumors. The likelihood of malignancy depends on factors like location, patient age, and symptoms.
This document discusses pediatric abdominal tumors and provides information on evaluating and characterizing various tumors through imaging modalities like ultrasound, CT, and MRI. Key tumors mentioned include Wilm's tumor of the kidney, cystic nephroma, clear cell sarcoma, rhabdoid tumor, neuroblastoma, hepatoblastoma, hepatocellular carcinoma, lymphoma, leukemia, and rhabdomyosarcoma. Imaging findings for different tumors are outlined to help determine the tumor type and guide diagnosis and treatment.
The document discusses central nervous system (CNS) tumors. It provides information on different types of primary and secondary brain tumors seen in adults and children, including meningiomas, gliomas such as astrocytomas and glioblastomas, medulloblastomas, and nerve sheath tumors. Key points covered include the typical locations, presentations, pathological features, and distinguishing characteristics of common CNS tumors.
This document provides information on intracranial space occupying lesions including classification, types of brain tumors, clinical manifestations, diagnostic measures, treatment options including surgery, radiation and chemotherapy, as well as postoperative complications. It classifies lesions as congenital, traumatic, inflammatory, parasitic or neoplastic and describes common tumor types such as gliomas, meningiomas and pituitary adenomas. Diagnostic tools include CT, MRI, PET and biopsy. Treatment involves surgery, radiation including gamma knife and brachytherapy, as well as chemotherapy.
Classification of brain tumors AND MANAGEMENT OG LOW GRADE GLIOMAradiation oncology
Low grade gliomas include diffuse astrocytomas, oligodendrogliomas, and oligoastrocytomas. They typically present with seizures and slowly progress. MRI is used to identify the location and extent of involvement. Treatment involves surgical resection when possible followed by monitoring as recurrence is common but progression to higher grades is slow.
Sam G, a 22-year-old previously healthy male, had a seizure while on a bus during a holiday. He became agitated and combative before having a generalized tonic-clonic seizure and becoming unresponsive. On examination, his pupils were minimally reactive and fundoscopy was normal. Differential diagnoses considered included epileptic seizure, CVA, CNS infection, brain tumor, drug withdrawal or overdose, and idiopathic epilepsy.
Jenna, a 27-year-old teacher, collapsed while teaching her class. She was witnessed to have a generalized tonic-clonic seizure. On examination, she had no signs of meningismus. Differential diagnoses considered included epilepsy,
A tumor is an abnormal growth of body tissue that can be either benign or malignant. A brain tumor is an abnormal growth of tissue in the brain and can be either a primary tumor that originates in the brain or a secondary tumor that spreads from another part of the body to the brain. Primary brain tumors include meningioma, which forms from the meninges, and ependymoma, which forms from the ependyma. Brain tumors can cause symptoms like headaches, nausea, balance problems, and memory issues depending on the size, type, and location of the tumor. Risk factors include increasing age, chemical exposure, and family history.
A 27-year-old female teacher collapsed in her classroom and was witnessed having a generalized tonic-clonic seizure by her students. She was brought to the emergency department by paramedics accompanied by a colleague. Differential diagnoses discussed include idiopathic epilepsy, meningitis, brain tumor, and other potential causes. Further workup is suggested to determine the underlying etiology.
The document discusses different types of brain tumors. It divides tumors into primary and metastatic brain tumors. Primary tumors originate within the brain itself and can be cancerous or non-cancerous. Metastatic tumors spread to the brain from other parts of the body and are always cancerous. Some types of non-cancerous primary brain tumors mentioned include meningiomas, pituitary adenomas, and schwannomas. Cancerous primary tumors include gliomas, the most common type. The document provides details on symptoms, treatment methods, and characteristics for several tumor types.
Sellar, Suprasellar and Pineal tumor final pk .pptDr pradeep Kumar
this is very good presentation slide for radiologist and radiology resident. our references is authentic and most are from osborn brain imaging 2nd edition. This deal with sellar, suprasellar and pineal tumor . This help alot. thanks
SHORT TALK ABOUT DIFFERENTIAL DIAGNOSIS ABOUT ADRENAL MASS LESION DDX, COMMON AND LESS COMMON CAUSES WITH CLUES TO DIAGNOSIS AND SOME EXAMPLES
HOPPING YOU LIKE IT
DR HISHAM ALKHATIB
CONSULTANT RADIOLOGIST
This document discusses extra-axial masses, specifically meningiomas. It provides details on the typical presentation, demographics, pathology, imaging features and diagnosis of meningiomas. On imaging, meningiomas usually appear as well-circumscribed, dural-based masses that enhance strongly with CT and MRI. They typically show calcification on CT and homogenous enhancement post-contrast. The document emphasizes that meningiomas are the most common extra-axial brain tumors and often appear as convexity or parasagittal masses, with females being more commonly affected.
This document discusses neck swelling, including thyroid swelling and cervical lymph node swelling. It defines neck swelling as any congenital or acquired mass in the neck region. It describes the differential diagnoses and approach to evaluating neck swelling, focusing on thyroid swelling and cervical lymph nodes. Investigations like ultrasound, biopsy, and blood tests are discussed for evaluating the cause of neck swelling, whether benign thyroid conditions, thyroid cancer, infections, or other issues. The importance of properly diagnosing and treating neck lumps is emphasized.
Testicular tumors are most common in men aged 18-35. The main risk factors include cryptorchidism and family history. Seminoma is the most common type, making up about 50% of germ cell tumors. Ultrasound is an important tool for evaluation, with solid and intra-testicular masses more likely to be malignant. Features on ultrasound can help distinguish between tumor types, such as seminomas appearing homogeneous and hypoechoic without calcification, while non-seminomatous germ cell tumors tend to be heterogeneous with cystic areas and calcification. MRI can also help characterize tumors based on signal characteristics and enhancement patterns.
TESTICULAR TUMOURS
PREVALANCE
99% of testicular tumours are malignant.
Life time prevalence of getting testicular tumour is 0.2%.
Very common in Scandinavia; least common inAfrica andAsia.
4 times common in whites than blacks.
retroperitoneal mass and retroperitoneal anatomyLeena Anjali
1. A large retroperitoneal mass with involvement of nearby vessels and necrosis suggests leiomyosarcoma. Neurofibromas and schwannomas show a target sign on MRI, while malignant fibrohistiocytoma, synovial sarcoma, and Ewing's sarcoma appear as a "bowl of fruit sign".
2. Lymphoma appears as an infiltrative, hypovascular mass around the aorta and vena cava without compression. Paraganglioma presents in young patients with high blood pressure and urine vanillylmandelic acid, appearing hypervascular on imaging.
3. Retroperitoneal liposarcomas are classified based on appearance, with well-different
The document discusses various lesions that can occur in the cerebellopontine angle region. The most common are acoustic neuromas and meningiomas, comprising 85-90% of lesions. Other lesions discussed include vestibular schwannomas, meningiomas, epidermoid cysts, dermoid cysts, arachnoid cysts, lipomas, aneurysms of posterior fossa arteries, and miscellaneous meningeal lesions such as carcinomatous meningitis. Key imaging features of each type of lesion are provided to help with differential diagnosis.
A variety of neoplasms can arise in the ventricular system, including ependymomas, medulloblastomas, subependymomas, central neurocytomas, subependymal giant cell astrocytomas (SGCA), choroid plexus papillomas, choroid plexus carcinomas, and intraventricular meningiomas. These lesions present variably with increased intracranial pressure, focal neurologic deficits, or incidentally found on imaging. Location within the ventricles and patient age, gender, and underlying conditions can help narrow the differential diagnosis.
Radiological imaging of intracranial cystic lesionsVishal Sankpal
This document provides information on intracranial cystic lesions, including their classification, etiology, imaging appearance and characteristics. It discusses both neoplastic and non-neoplastic cysts, as well as infectious and congenital cysts. Specific cysts covered include arachnoid cysts, dermoid cysts, epidermoid cysts and neuroglial cysts. For each type of cyst, the document provides details on location, appearance on CT, MRI, differential diagnosis and treatment.
imaging of scrotum [Repaired] [Repaired].pptxdypradio
The scrotum contains the testes and epididymides. On ultrasound, the normal anatomy includes the oval testes with homogeneous echotexture and color flow. Potential pathological findings include infections like epididymitis, tumors such as seminomas which appear hypoechoic and well-defined, and traumatic injuries or torsion which may demonstrate absent flow. Malignancies require evaluation for metastases while infections require treatment with antibiotics. Imaging guides diagnosis and management of scrotal pathologies.
This document discusses mediastinal tumors, including:
1. It provides an overview of the anatomy of the mediastinum and introduces the wide variety of mediastinal masses that can be benign or malignant, primary or secondary.
2. The clinical presentation of mediastinal masses is discussed, noting that most are asymptomatic but can cause symptoms depending on location, nature, and associated conditions.
3. Diagnostic workups including imaging modalities like CT, MRI, and ultrasound are outlined to characterize masses based on features. Biopsy approaches are also covered.
The parapharyngeal space is a potential space located in the neck that contains important structures like the carotid artery and cranial nerves. Tumors in this space can be benign or malignant, with the most common types being salivary gland tumors in the prestyloid space and neurogenic tumors in the retrostyloid space. Imaging like CT and MRI are used to determine the location and characteristics of the tumor. Surgical excision is typically the primary treatment, with the surgical approach depending on factors like size and involvement of surrounding structures. Observation or radiation therapy may be options for certain patients who cannot undergo surgery.
This document discusses carcinoma of the rectum, including its etiology, pathology, staging, clinical features, investigations, differential diagnosis, and treatment options. Some key points:
- Carcinoma of the rectum is more common in females and usually originates from pre-existing adenomas or polyps. Risk factors include diet high in red meat/saturated fat and low in fiber, as well as smoking, alcohol, family history, and certain medical conditions.
- Pathologically, most are adenocarcinomas that may be well, moderately, or undifferentiated. Staging systems include Duke's and TNM classification. Clinical features include bleeding, anemia, and symptoms of bowel obstruction.
Renal tumors can be benign or malignant. Benign renal tumors include cysts, oncocytomas, angiomyolipomas, and papillary adenomas. Malignant renal tumors mainly consist of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer and its incidence is rising. Risk factors for RCC include smoking, obesity, hypertension, and family history. RCC is diagnosed using imaging tests like ultrasound, CT scan, MRI and biopsy when needed. RCC is classified based on histology and the TNM staging system is used to determine prognosis and treatment.
The patient is a 60-year-old female presenting with 11 months of hearing difficulty and headaches, as well as 3 months of gait difficulties, urinary incontinence, and dementia. Imaging shows a mass in the cerebellopontine angle. The document discusses the differential diagnosis and features of common cerebellopontine angle masses including vestibular schwannoma, meningioma, and epidermoid cyst based on their location, imaging characteristics, and other distinguishing clinical and radiological features to determine the most likely diagnosis.
This document summarizes common focal liver lesions that can be seen on multiphasic CT scans. It describes key features of benign lesions such as hemangioma and focal nodular hyperplasia as well as malignant lesions including hepatocellular carcinoma, cholangiocarcinoma, and metastases. Characteristics of each lesion like appearance on different phases of CT and other modalities like MRI are discussed. Differential features between lesions are also provided to aid in diagnosis.
A 40-year-old female presented with progressive vision impairment and headaches. MRI showed a well-defined suprasellar mass compressing surrounding structures and enhancing with a dural tail. Radiological findings were consistent with a suprasellar meningioma extending along the planum sphenoidale and dorsum sellae. Meningiomas typically originate from arachnoid cells, are most common in the supratentorial compartment, and demonstrate avid enhancement with a dural tail on MRI. Surgical resection aims to remove the tumor and involved dura.
The heart begins developing early in embryogenesis from multiple cell populations that form heart tubes. These tubes then fuse and undergo looping to form the primitive heart chambers. Partitioning of these chambers occurs through formation of endocardial cushions and septa, which divide the heart into four chambers. This includes division of the atria by the septum primum and secundum, and division of the ventricles by the interventricular septum. Concurrently, the heart valves, conduction system, and great arteries such as the aorta and pulmonary trunk develop through proliferation of cardiac tissue. By the end of the eighth week of development, the partitioning is largely complete resulting in the basic four-chambered structure of the adult heart
Aortopulmonary collaterals connect the systemic and pulmonary circulations, benefiting pulmonary blood flow but also increasing pulmonary pressure and risk of hemoptysis. The Amplatzer vascular plug was created as a modification of septal occluders to embolize vessels, consisting of a nitinol mesh disk delivered via a torqueable wire. It promotes clot formation to occlude vessels and can be retrieved or repositioned before detachment. While it reduces risks like migration in high flow situations, challenges include device advancement, persistent patency, and cost.
The document discusses x-rays and how they are produced and used. It explains that Wilhelm Roentgen discovered x-rays in 1895 while experimenting with cathode rays. X-rays are a form of electromagnetic radiation produced when high-voltage electrons interact with a metal target. X-ray film contains silver halide that darkens when exposed to x-rays, allowing radiographic images to be viewed. The document also covers x-ray positioning terminology, different body positions used for x-rays, and factors that define a technically adequate chest x-ray.
- Gastrointestinal carcinoid tumors most commonly occur in the small bowel and appendix. They arise from enterochromaffin cells and can produce symptoms if they secrete excess serotonin.
- Diagnosis is usually achieved through complementary imaging techniques such as somatostatin receptor scintigraphy, CT, MRI, and ultrasound. Somatostatin receptor scintigraphy is particularly useful for detecting primary tumors and metastases.
- Imaging findings include well-defined bowel masses that can invade the mesentery, associated lymphadenopathy, and liver metastases appearing as hypoechoic lesions that enhance with contrast.
This document provides an overview of imaging in acute stroke. It discusses the goals of imaging evaluation for acute stroke which are to establish a diagnosis, guide treatment, assess location and size of involved territory, rule out hemorrhage and mimics, and obtain information about vasculature and perfusion. CT is the first-line test and can detect early signs of stroke within 6 hours. MRI, including DWI, is very sensitive for acute ischemia. CT angiography and perfusion can assess vessels, blood flow, and the ischemic penumbra. Different territories are discussed along with imaging findings and the physical basis of signs seen on various sequences.
This document provides an overview of different types of brain hemorrhages, including extra-axial hemorrhages such as epidural, subdural, and subarachnoid hemorrhages as well as intra-axial intracerebral hemorrhages. CT scans are used to initially diagnose hemorrhages by identifying hyperdense blood. Characteristics, locations, imaging appearances, and complications of each type of hemorrhage are described in detail. The document aims to inform clinicians on the basics and distinguishing features of various brain hemorrhages.
A 50-year-old male patient presented with headaches for two years and progressive vision loss over three months. MRI revealed a pituitary macroadenoma, which are large pituitary tumors that cause symptoms through mass effect. Macroadenomas share characteristics with smaller tumors on MRI, appearing hypointense on T1-weighted images and hyperintense on T2-weighted images. The macroadenoma in this case completely filled the sella turcica. Criteria for determining if a macroadenoma has invaded the cavernous sinus include intact pituitary tissue between the tumor and sinus, an intact medial venous compartment, and less than 25% encasement of the internal carotid artery. Post-operative Gelfo
- Alveolar lung disease (ALD) refers to the filling of airspaces in the lungs with fluid or other materials.
- ALD can be caused by conditions such as pulmonary edema, hemorrhage, pneumonia, aspiration, and alveolar proteinosis. Acute ALD often resolves quickly but can recur, while chronic ALD persists over months.
- Chest x-rays are useful for diagnosing ALD and distinguishing between acute and chronic causes. Features include bilateral airspace opacities, consolidation, and clearing seen with acute conditions versus stable opacities with chronic conditions. The distribution and associated findings provide clues to the underlying condition.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
Thinking of getting a dog? Be aware that breeds like Pit Bulls, Rottweilers, and German Shepherds can be loyal and dangerous. Proper training and socialization are crucial to preventing aggressive behaviors. Ensure safety by understanding their needs and always supervising interactions. Stay safe, and enjoy your furry friends!
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
2. WHO classification
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Tumors of the Sellar Region
Hematopoietic tumors
Germ Cell Tumors
Tumors of the Meninges
Non-menigothelial tumors of the meninges
Tumors of Cranial and Spinal Nerves
Local Extensions from Regional Tumors
Metastatic tumours
Unclassified Tumors
Cysts and Tumor-like Lesions
3. • Tumors of the Sellar Region
– Pituitary adenoma
– Pituitary carcinoma
– Craniopharyngioma
9. • Local Extensions from Regional Tumors
– Paraganglioma (chemodectoma)
– Chordoma
– Chondroma
– Chondrosarcoma
– Carcinoma
10. Primary CNS lymphoma
• Malignant primary CNS neoplasm composed of B lymphocytes
• Enhancing lesion(s) within basal ganglia, periventricular WM
• 90% supratentorial
• Frontal and parietal lobes most common
• Deep gray nuclei commonly affected
• Lesions cluster around ventricles, GM-WM junction
• Often involve, cross corpus callosum
• Frequently abut, extend along ependymal surfaces
11. •
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NECT
Hyperdense classically
May be isodense
+/- Hemorrhage, necrosis (immunocompromised)
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•
•
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CECT
Common: Moderate, uniform (immunocompetent)
Less common: Ring (immunocompromised)
Rare: Nonenhancing (infiltrative, mimics white matter disease)
12. • MR Findings
• T1WI
• Immunocompetent: Homogeneous isointense/hypointense to cortex
• Immunocompromised: Isointense/hypointense to cortex
– May be heterogeneous from hemorrhage, necrosis
• T2WI
• Immunocompetent: Homogeneous isointense/hypointense to cortex
– Hypointensity related to high nuclear to cytoplasmic ratio
• Immunocompromised: Isointense/hypointense to cortex
– May be heterogeneous from hemorrhage, necrosis
– Ca++ may rarely be seen, usually after therapy
• Mild surrounding edema is typical
13. •
•
•
•
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FLAIR
Immunocompetent: Homogeneous isointense/hypointense to cortex
Immunocompromised: Isointense/hypointense
May be hyperintense
Mild surrounding edema is typical
•
T2* GRE: May see blood products or calcium as areas of "blooming" (immunocompromised)
•
DWI: Restricted diffusion, low ADC map reported
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•
•
•
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T1 C+
Immunocompetent: Strong homogeneous enhancement
Immunocompromised: Peripheral enhancement with central necrosis or homogeneous
enhancement
Nonenhancement extremely rare
Lymphomatous meningitis is typically related to systemic disease
•
•
•
MRS
NAA decreased, Cho elevated
Lipid and lactate peaks reported
•
MR perfusion: Early studies show increased rCBV
14.
15.
16. Angiocentric lymphoma
• Rare malignancy characterized by intravascular proliferation of lymphoid
cells with a predilection for CNS and skin
• A form of non-Hodgkin lymphoma (NHL) characterized by angiotropic
growth
• Multifocal abnormal T2 hyperintensity in deep WM, cortex or basal ganglia
+ enhancement
• Supratentorial (periventricular/deep WM, G-W junction)
• May involve basal ganglia (BG), midbrain
• NECT: Focal, bilateral asymmetric low density lesions inWM, cortex, or
basal ganglia
• CECT: Variable (none to moderate)
17. •
•
•
T1 WI
Multifocal hypointense lesions
May see blood products
•
•
•
•
T2WI
45% hyperintensities in deep WM (edema, gliosis)
36% cortex hyperintensity, infarct-like lesions
May see hemorrhagic transformation
•
T2* GRE: May see blood products "blooming“
•
DWI: Diffusion restriction reported
•
•
•
T1 C+
Variable enhancement: Linear, punctate, patchy, nodular, ring-like, gyriform, homogeneous
o Meningeal and/or dural enhancement
18.
19.
20. Germinoma
•
Morphologic homologues of germinal neoplasms arising in the gonads and
extragonadal sites
•
Pineal region mass that "engulfs" the pineal gland
•
Midline near the 3rd ventricle - 80-90% (Pineal region - 50-65%, Suprasellar - 2535%, Basal ganglia and thalami - 5-10%)
NECT
• Sharply circumscribed dense mass (hyperdense to GM)
• Pineal: Mass drapes around posterior 3rd ventricle or "engulfs" pineal gland
• Suprasellar: Retrochiasmatic, non-cystic, non -calcified
• ± Hydrocephalus
CECT
• Strong uniform enhancement, ± CSF seeding
• Cystic/necrotic/hemorrhagic components not uncommon with larger germinomas
(especially in basal ganglia)
21. • T1Wl
• Isointense or hyperintense to GM
• Early cases may only show absent posterior pituitary bright spot
•
•
•
•
T2Wl
Iso-to-hyperintense to GM (high nuclear:Cytoplasmic ratio)
Cystic or necrotic foci (high T2 signal)
Less common: Hypointense foci (hemorrhage)
• FLAIR: Slightly hyperintense to GM
• T2* GRE: Calcification, hemorrhage (rare)
• DWI: Restricted diffusion due to high cellularity
• T1 C+: Strong, homogeneous enhancement, ± CSF seeding, ± brain
invasion
• MRS: inc Choline, dec NAA, ± lactate
22.
23.
24.
25. Teratoma
• Tridermal mass originating from displaced embryonic tissue that is
misenfolded
• Midline mass containing: Ca++, soft tissue, cysts, and fat
• Hugs midline, optic chiasm, pineal gland (Majority are
supratentorial)
• NECT: Fat, soft tissue, Ca++, cystic attenuation
• CECT: Soft tissue components enhance
26. MR Findings
• T1WI: inc signal from fat, variable signal from Ca++
• T2WI: Soft tissue components iso- to hyperintense
• FLAIR: dec signal from cysts, inc signal from solid tissue
• T2* GRE: dec signal from Ca++
• T1 C+: Soft tissue enhancement
• MRS: inc lipid moieties on short echo
27.
28.
29. Embryonal carcinoma
• Malignant tumor composed of undifferentiated cells
• Heterogeneous pineal or suprasellar mass in adolescent
• Hugs midline as other CNS GCTs
• Typically well circumscribed or lobulated
• NECT – Heterogenous - Isoattenuating to hyperattenuating
• CECT - Enhancing, ± cysts, hemorrhage
30. T1WI
• Hypointense to isointense to GM
• T1 shortening due to protein, blood or fat
T2WI: Isointense to slightly hyperintense to GM
FLAIR
• Hyperintense solid elements
• ± Hydrocephalus
T2* GRE: Dephasing from hemorrhagic foci
DWI: ± Restriction within solid components
T1 C+: Heterogeneous enhancement, ± CSF spread
MRS: inc Choline, inc lipid and lactate, dec NAA
31.
32.
33. Meningioma
• WHO grade 1 Meningioma
• Dural-based enhancing mass w/cortical buckling & trapped CSF
clefts/cortical vessels
• Supratentorial (90%): Para sagittal/convexity (45%), sphenoid ridge (1520%), olfactory groove (5-10%), parasellar (5-10%)
• Infratentorial (8-10%): CPA most common
• Misc inside the dural: Intraventricular, optic nerve sheath, pineal region
• Misc outside the dura: Paranasal sinus (most common), nasal
cavity, parotid, skin, calvarium
34. •
•
•
•
•
•
•
•
•
NECT
Hyperostosis, irregular cortex, tumoral calcifications, inc vascular markings
Sharply circumscribed smooth mass abutting dura
Hyperdense (70-75%), iso- (25%), hypo- (1-5%)
Calcified (20-25%): Diffuse, focal, sandlike, sunburst, globular, rim
Necrosis, cysts, hemorrhage (8-23%)
Rare lipoblastic subtype
Brain cysts & trapped pools of CSF common
Peritumoral hypodense vasogenic edema (60%)
• CECT: > 90% enhance homogeneously & intensely
• CTA: May complement DSA in defining vascular supply to tumor & normal
tissues from each feeder artery before embolization
35. •
•
•
•
T1WI
Usually iso- to slightly hypointense with cortex
Necrosis, cysts, hemorrhage (8-23%)
Best to visualize gray matter "buckling“
•
•
•
•
T2WI
Variable; sunburst pattern may be evident
Necrosis, cysts, hemorrhage (8-23%)
Best to visualize trapped hyperintense CSF clefts (80%) & vascular flow
voids (80%)
• FLAIR: Hyperintense peritumoral edema, dural "tail“
• T2* GRE: Best sensitivity for calcification
• DWI: DWI, ADC maps for CM variable in appearance
36. •
•
•
•
T1 C+
> 95% enhance homogeneously & intensely
Dural "tail" (35-80% of cases ): Non-specific
En plaque: Sessile thickened enhancing dura
•
MRV: Evaluate possible sinus involvement
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•
MRS
Elevated levels of Alanine at short TE
•
Reported peak ranges from 1.3-1.5 ppm
•
Perfusion MRI: Good correlation between volume transfer constant (K-trans) &
histologic grade
37.
38.
39.
40. Atypical and malignant meningioma
Common meningioma = WHO grade 1 meningioma
Atypical meningioma = WHO grade 2 meningioma
Malignant meningioma = WHO grade 3 meningioma
•
Dural based lesion locally invasive with areas of necrosis & marked brain edema
•
Occur anywhere along neuraxis
•
AM: Para sagittal (44%), cerebral convexities (16%)
•
•
•
•
NECT
Hyperdense w/minimal or no calcification
Marked perifocal edema & bone destruction
CT "Triad" of MM: Extracranial mass, osteolysis, & intracranial tumor
•
•
•
CECT
Enhancing tumor mass
Prominent pannus or tumor, extending away from mass termed "mushrooming"
41. •
•
•
T1WI
Indistinct tumor margins
Extending tumor interdigitating with brain
•
FLAIR:Marked peritumoral edema
•
•
•
•
DWI
Markedly hyperintense on DWI
Marked decrease in ADC
Correlates with histopathology
•
•
•
T1 C+
Enhancing tumor mass
Plaque like & may extend into brain, skull, scalp
•
MRV: Evaluate possible sinus involvement
•
•
MRS - Elevated levels of Alanine at short TE
Reported peak ranges from 1.3-1.5 ppm
42.
43.
44.
45. Hemangioblastoma
• Vascular neoplasm of uncertain histogenesis
• Adult with intra-axial posterior fossa mass with cyst, enhancing mural
nodule abutting the pia
• 90-95% posterior fossa ( 80% cerebellar hemisphere )
• 60% cyst with mural nodule ( 40% solid )
• NECT – low density cyst with isodense mural nodule
• CECT – Nodule enhances intensely, Cyst wall doesn’t enhance
• CTA – may demostrate arterial feeders
46. T1 WI
• Nodule isointense with brain
• Cyst moderately hyperintense to CSF
T2 WI
• Both nodule and cyst are hyperintense
• Prominent flow voids in some cases
FLAIR
• Both cyst and nodule hyperintense
T1 C+
• Nodule enhances intensely
• Solid enhancement pattern less common
• Cyst wall enhancement very less common
•
•
20-40 % HGBL occur in VHL patients (multiple tumors)
With visceral cysts, RCC
47.
48.
49.
50. Hemangiopericytoma
• Sarcoma related to neoplastic transformation of pericytes
• Lobular enhancing extra-axial mass with dural attachment +/- skull
erosion
• Supratentorial – occipital region most common
• NECT – hyperdense extra-axial mass with surrounding
edema, calvarial erosion
• CECT – strong heterogenous enhancement
No Ca++ or hyperostosis
51. • T1 WI
• Heterogenous mass, isointense to gray matter
•
•
•
•
•
T2 WI
Heterogenous isointense mass
Prominent flow voids are common
Surrounding edema, mass effect are common
Hydrocephalus
• T1 C+
• Marked heterogenous enhancement
• Dural tail seen in 50%
• MRV – occlusion of venous sinuses
• MRS – elevated myoinositol
52. • Local recurrence common, 50-80%
• Extracranial metastases common, up to 30%
• Commonly liver, lungs, lymph nodes, bones
Staging, Grading or Classification Criteria
• WHO grade II or III (anaplastic)