Thalamic glioma
Updates to Case Attributes
CT and MRI demonstrates a left thalamic lesion. Follow up study after initiation of radio-chemotherapy demonstrates mild reduction in the size of the left thalamic lesion.
Pathology:
Immunohistochemistry:
GFAP (clone polyclonal) is positive (weak)
Ki-67 (MMI) approximatlyapproximately 1% nuclear staining
P53 (D0-7) is positive.
Low grade-grade glial tumour consistent with astrocytoma WHO grade II. Sections consist with predominantly graygrey and white matter brain tissue with only small fragment of increased cellularity consistent with low grade-grade astrocytoma of WHO grade II. However, in view of the small size of the biopsy material this grade might be not representative of the actual grade of the tumour so correlation with radiological finding is mandatory.
It should be noted that the biopsy is not from the enhancing component,located posteriorly. With enhancement and such a high choCho:cr ratio, Iwould have guessed anapestic / Grade III astrocytoma. So there may well be, as the pathologist says, sampling error.
The enhancing nodules on follow up MRI are presumably from the biopsy.
-<p>CT and MRI demonstrates a left thalamic lesion. Follow up study after initiation of radio-chemotherapy demonstrates mild reduction in the size of the left thalamic lesion. </p><p><strong>Pathology:</strong></p><p>Immunohistochemistry:</p><p>GFAP (clone polyclonal) is positive (weak)</p><p>Ki-67 (MMI) approximatly 1% nuclear staining </p><p>P53 (D0-7) is positive.</p><p>Low grade glial tumour consistent with astrocytoma WHO grade II . Sections consist with predominantly gray and white matter brain tissue with only small fragment of increased cellularity consistent with low grade astrocytoma of WHO grade II . However, in view of the small size of the biopsy material this grade might be not representative of the actual grade of the tumour so correlation with radiological finding is mandatory.</p><p>It should be noted that the biopsy is not from the enhancing component,<br />-located posteriorly. With enhancement and such a high cho:cr ratio, i<br />-would have guessed anapestic / Grade III astrocytoma. So there may well be, as the pathologist says, sampling error.</p><p>The enhancing nodules on follow up MRI are presumably from the biopsy.</p>- +<p><strong>Pathology:</strong></p><p>Immunohistochemistry:</p><p>GFAP (clone polyclonal) is positive (weak)</p><p>Ki-67 (MMI) approximately 1% nuclear staining</p><p>P53 (D0-7) is positive.</p><p>Low-grade glial tumour consistent with astrocytoma WHO grade II. Sections consist with predominantly grey and white matter brain tissue with only small fragment of increased cellularity consistent with low-grade astrocytoma of WHO grade II. However, in view of the small size of the biopsy material this grade might be not representative of the actual grade of the tumour so correlation with radiological finding is mandatory.</p><p>It should be noted that the biopsy is not from the enhancing component,<br>located posteriorly. With enhancement and such a high Cho:cr ratio, I<br>would have guessed anapestic / Grade III astrocytoma. So there may well be, as the pathologist says, sampling error.</p>
Systems changed:
- Oncology
Updates to Study Attributes
MRI demonstrates a left thalamic lesion with no diffusion restriction and mild postcontrast heterogeneous enhancement. High choline peak is noted on MR-spectroscopy.
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image MRI (DWI) ( update )
Image MRI (FLAIR) ( update )
Image MRI (Gradient Echo) ( update )
Image MRI (T2) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image MRI (MRS) ( update )
Image MRI (ADC) ( update )
Image 4 MRI (ADC) ( update )
Image 5 MRI (FLAIR) ( update )
Image 6 MRI (Gradient Echo) ( update )
Image 7 MRI (T2) ( update )
Image 8 MRI (T1 C+) ( update )
Image 9 MRI (MRS) ( update )
Updates to Study Attributes
Follow up study after initiation of radio-chemotherapy demonstrates mild reduction in the size of the left thalamic lesion. The enhancing nodules are presumably from the biopsy site.
Image MRI (T1) ( update )
Image MRI (T1) ( update )
Image MRI (T2) ( update )
Image MRI (T1) ( update )
Image MRI (FLAIR) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image 1 MRI (T1) ( update )
Image 2 MRI (T2) ( update )
Image 3 MRI (FLAIR) ( update )
Image 4 MRI (T1) ( update )
Image 5 MRI (T1) ( update )
Image 6 MRI (T1 C+) ( update )
Image 7 MRI (T1 C+) ( update )
Image 8 MRI (T1 C+) ( update )
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