Medulloblastoma - adult
Updates to Study Attributes
CT demonstratesThere is a mixed solid and cystic mass surrounded by peritumoural oedema within the left cerebellar hemisphere. Is is composed of mixed solid and cystic components and is surrounded by tumour oedema.
The solid component appears slightly hyperdense. Following administration of contrast, vivid enhancement of the solid component is present.
Image CT (C+ delayed) ( update )
Updates to Study Attributes
MRI demonstrates a mass within the left cerebellar hemisphere. IsIt is composed of mixed solid and cystic components and is surrounded by a mantle of tumourwith peritumoural oedema.
The solid component demonstrates demonstrates restricted diffusion on DWI. Following administration of contrast, vivid and avid enhancement of the solid component is presentpost contrast administration.
Image MRI (T1) ( update )
Image MRI (FLAIR) ( update )
Image MRI (Gradient Echo) ( update )
Image MRI (MR Perfusion) ( update )
Image MRI (DWI) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image MRI (T1 C+) ( update )
Image 6 MRI (DWI) ( update )
Image 7 MRI (T1 C+) ( update )
Image 8 MRI (T1 C+) ( update )
Image 9 MRI (T1 C+) ( update )
Updates to Case Attributes
The differential is of a haemangioblastoma, high grade glioma, a metastasis or of an adult medulloblastoma. The hypderdensity, exceticexccentric location, and restricted diffusion are all consistent with the latter,confirmed confirmed at pathology.
Histology
Microscopic Description:
Sections show a highly cellular tumour mass composed of cells with hyperchromatic oval nuclei and little visible cytoplasm. The nuclei have coarsely clumped chromatin and inconspicuous nucleoli. Mitotic activity and individual cell necrosis and apoptosis are frequent. In some areas, the nuclei show a tendency to mold to one another. The cells are arranged in solid disorganized sheets and in small lobules and columns separated by collagenous septa. Multiple small cystic spaces are present but there is no geographic necrosis. One small fragment of recognizable cerebellar cortex is present and shows diffuse infiltration by neoplastic cells. Immunohistochemistry shows diffuse cytoplasmic reactivity for NSE and synaptophysin and occasional cells are positive for GFAP and S-100. The tumour is negative for cytokeratin, LCA, HMB-45 and Mel A.
Final diagnosis: Medulloblastoma
-<p><span style="line-height:1.6">The differential is of a </span>haemangioblastoma<span style="line-height:1.6">, </span>high grade glioma<span style="line-height:1.6">, a </span>metastasis<span style="line-height:1.6"> or of an adult </span><a style="line-height: 1.6;" href="/articles/medulloblastoma">medulloblastoma</a>. The hypderdensity, excetic location, and restricted diffusion are all consistent with the latter, <span style="line-height:1.6">confirmed at pathology. </span></p><p><strong>Histology</strong></p><p>Microscopic Description:</p><p>Sections show a highly cellular tumour mass composed of cells with hyperchromatic oval nuclei and little visible cytoplasm. The nuclei have coarsely clumped chromatin and inconspicuous nucleoli. Mitotic activity and individual cell necrosis and apoptosis are frequent. In some areas, the nuclei show a tendency to mold to one another. The cells are arranged in solid disorganized sheets and in small lobules and columns separated by collagenous septa. Multiple small cystic spaces are present but there is no geographic necrosis. One small fragment of recognizable cerebellar cortex is present and shows diffuse infiltration by neoplastic cells. Immunohistochemistry shows diffuse cytoplasmic reactivity for NSE and synaptophysin and occasional cells are positive for GFAP and S-100. The tumour is negative for cytokeratin, LCA, HMB-45 and Mel A.</p><p>Final diagnosis: <a title="Medulloblastomas" href="/articles/medulloblastoma">Medulloblastoma</a></p><p> </p>- +<p>The differential is of a haemangioblastoma, high grade glioma, a metastasis or an adult <a href="/articles/medulloblastoma">medulloblastoma</a>. The hypderdensity, exccentric location, and restricted diffusion are all consistent with the latter, confirmed at pathology. </p><p><strong>Histology</strong></p><p>Microscopic Description:</p><p>Sections show a highly cellular tumour mass composed of cells with hyperchromatic oval nuclei and little visible cytoplasm. The nuclei have coarsely clumped chromatin and inconspicuous nucleoli. Mitotic activity and individual cell necrosis and apoptosis are frequent. In some areas, the nuclei show a tendency to mold to one another. The cells are arranged in solid disorganized sheets and in small lobules and columns separated by collagenous septa. Multiple small cystic spaces are present but there is no geographic necrosis. One small fragment of recognizable cerebellar cortex is present and shows diffuse infiltration by neoplastic cells. Immunohistochemistry shows diffuse cytoplasmic reactivity for NSE and synaptophysin and occasional cells are positive for GFAP and S-100. The tumour is negative for cytokeratin, LCA, HMB-45 and Mel A.</p><p>Final diagnosis: <a href="/articles/medulloblastoma">Medulloblastoma</a></p><p> </p>
Systems changed:
- Oncology