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Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach.

Pant I, Chaturvedi S, Jha DK, Kumari R, Parteki S - J Neurosci Rural Pract (2015 Apr-Jun)

Bottom Line: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system.Lowest concordance was seen in low-grade astrocytomas.In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Institute of Human Behaviour and Allied Sciences, Delhi, India.

ABSTRACT

Objective: This study was conducted to formulate location-wise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis so as to evaluate their utility in a rural setting where only basic facilities are available.

Materials and methods: A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared.

Results: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system. Lowest concordance was seen in low-grade astrocytomas. In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors.

Conclusion: A location-based approach to central nervous system (CNS) tumors is helpful in establishing an appropriate differential diagnosis.

No MeSH data available.


Related in: MedlinePlus

Diagnostic algorithm for supratentorial extraaxial CNS tumors
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Figure 3: Diagnostic algorithm for supratentorial extraaxial CNS tumors

Mentions: A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared according to six major locations (supratentorial intraaxial parenchymal, supratentorial intraaxial ventricular, supratentorial extraaxial, infratentorial intraaxial parenchymal, infratentorial intraaxial ventricular, infratentorial extraaxial) [Figures 1a–c and 2a–c]. The basic radiological features taken into consideration were: Margins (well defined, ill defined, and infiltrative), signal (homogenous and heterogeneous), contents (necrosis, hemorrhage and calcification), diffusion signal (restricted, not restricted, and partially restricted), edema (mild, moderate, severe, and absent), mass effect (present and absent), bony changes (with scalloping, erosion, and absent), and pattern of enhancement (homogenous, heterogeneous, and dural tail sign) [Figure 3]. Rare tumor locations and radiological findings were excluded. Differential diagnoses were arrived at based on these algorithms. A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done in 204 cases of CNS tumors.


Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach.

Pant I, Chaturvedi S, Jha DK, Kumari R, Parteki S - J Neurosci Rural Pract (2015 Apr-Jun)

Diagnostic algorithm for supratentorial extraaxial CNS tumors
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4387810&req=5

Figure 3: Diagnostic algorithm for supratentorial extraaxial CNS tumors
Mentions: A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared according to six major locations (supratentorial intraaxial parenchymal, supratentorial intraaxial ventricular, supratentorial extraaxial, infratentorial intraaxial parenchymal, infratentorial intraaxial ventricular, infratentorial extraaxial) [Figures 1a–c and 2a–c]. The basic radiological features taken into consideration were: Margins (well defined, ill defined, and infiltrative), signal (homogenous and heterogeneous), contents (necrosis, hemorrhage and calcification), diffusion signal (restricted, not restricted, and partially restricted), edema (mild, moderate, severe, and absent), mass effect (present and absent), bony changes (with scalloping, erosion, and absent), and pattern of enhancement (homogenous, heterogeneous, and dural tail sign) [Figure 3]. Rare tumor locations and radiological findings were excluded. Differential diagnoses were arrived at based on these algorithms. A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done in 204 cases of CNS tumors.

Bottom Line: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system.Lowest concordance was seen in low-grade astrocytomas.In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Institute of Human Behaviour and Allied Sciences, Delhi, India.

ABSTRACT

Objective: This study was conducted to formulate location-wise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis so as to evaluate their utility in a rural setting where only basic facilities are available.

Materials and methods: A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared.

Results: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system. Lowest concordance was seen in low-grade astrocytomas. In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors.

Conclusion: A location-based approach to central nervous system (CNS) tumors is helpful in establishing an appropriate differential diagnosis.

No MeSH data available.


Related in: MedlinePlus