Anaplastic astrocytoma (WHO grade III)
45 year old female with heaviness and numbness in the left upper limb. Few attacks of convulsions started in the last week.
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- right fronto-parietal cortical and subcortical mass lesion is seen demonstrating heterogenous predominantly low T1 with patchy areas of T1 hyperintensity (met Hb sign) as well as heterogeneously hyperintense T2 / FLAIR signal. The lesion shows some restricted diffusion.
- the lesion shows mild heterogenous post-contrast enhancement.
- the lesion is surrounded by mild vasogenic brain oedema with compression of the right lateral ventricle as well as subtle about 3 mm contra-lateral midline shift.
- MR spectroscopy of the examination shows:
- marked elevation of the choline (Cho) with moderate depression of the neuronal markers N-acetyl aspartate (NAA) and creatine (Cr) with elevation of the Cho / Cr and Cho / NAA rations
- Myoinositol (MI) is not significantly depressed, with MI / Cr ratio ~ 0.53
- single voxel MR spectroscopy show mild elevation of the lipid / lactate peak
- no hydrocephalic changes
- normal sellar region
- normal posterior fossa.
Right fronto-parietal haemorrhagic mass lesion with mild mass effect.
Conventional and spectroscopic features of anaplastic astrocytoma (WHO grade III)