Ganglioglioma

Case contributed by Dr Bruno Di Muzio

Presentation

Temporal lobe epilepsy.

Patient Data

Age: 40-year-old
Gender: Female

MRI Brain

Modality: MRI

When compared to the previous MRI brain the 12 mm cystic lesion in the inferomedial aspect of the left anterior temporal pole with surrounding flair hyperintense focus of cortical expansion has not increased in size. It demonstrates minimal choline elevation with no NAA depression or lactate peak on spectroscopy. No cerebral blood volume (CBV) increase. No diffusion restriction. On the post contrast sequences there is impression of enhancement, however this region does contain phase artefact related to the skull base vessels.

Remainder the brain is within expected limits.

Modality: Pathology

MICROSCOPIC DESCRIPTION: 1-6. All the sections contain tumour which is moderately cellular. The glial cells have elongated, angulated and hyperchromatic nuclei. Some fascicular arrangement is noted. Scattered dysmorphic neurons are seen, intermixed with the glial cells. They are haphazardly arranged. Some are binucleated. They have nucleomegaly. Mitoses are inconspicuous. No microvascular proliferation or necrosis is present. Occasional eosinophilic granular bodies are noted. There is no oligodendroglial component. The adjacent cortex shows cortical dysplasia with disorganised neurons but no balloon cells (FCD Type IIIb). Some of the tumour cells are GFAP positive and other cells NeuN and synaptophysin positive, indicating both glial and neuronal differentiation. IDH-1 and MGMT are negative. The topoisomerase index is 1-2%. ATRX shows no loss of staining (non-mutated). The features appear to show a low rade glioneuronal tumour, consistent with a ganglioglioma.

DIAGNOSIS: 1-6. Left temporal tumour: Low grade glioneuronal tumour, consistent with a ganglioglioma (WHO Grade I).

Case Discussion

The imaging features of this case are those of a low-grade tumour such as ganglioglioma or DNET. Histopathology confirmed to be a ganglioglioma. 

PlayAdd to Share

Case Information

rID: 44042
Case created: 4th Apr 2016
Last edited: 4th Apr 2016
Tag: rmh
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.