Biomedical subjects
Publications and source records attributed to L G Naul.
Hemangiopericytoma (HP) is a rare vascular tumor that usually occurs in adults, but 10% occur in children. Tumors occurring in the first year of life are even more rare and are referred to as infantile hemangiopericytoma. In this article, we report the imaging, operative, and pathological findings in a patient with an infantile HP.
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We report a case of diffuse enhancement of the cerebrospinal fluid (CSF) after intravenous administration of gadopentetate dimeglumine in an 8-year-old girl with a primitive neuroectodermal tumor. The enhancement of the CSF was caused by leakage of gadolinium chelate complexes into the CSF, which was proved by CSF analysis.
Arachnoid cysts of the spinal canal are relatively common lesions that may be either intra- or extradural. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots. We report a case in which an intradural thoracic arachnoid cyst became symptomatic after a routine decompressive lumbar laminectomy for spinal stenosis. Myelography revealed no abnormality, although magnetic resonance imaging and computed tomography after myelography demonstrated a mass within the posterior aspect of the thoracic spinal canal associated with anterior displacement and compression of the spinal cord. A change in the flow dynamics of the cerebrospinal fluid probably allowed the development of spinal cord compression due to one of the following: expansion of the cyst, decreased cerebrospinal fluid buffer between the cord and the cyst, or epidural venous engorgement. A concomitant and more cephalad lesion such as an arachnoid cyst should be considered when myelopathic complications arise after lumbar surgery. Magnetic resonance imaging and computed tomography after myelography are useful to demonstrate the additional pathological processes.
Five patients with plain radiographic evidence of a compressed vertebra containing an intravertebral vacuum cleft indicative of avascular necrosis underwent magnetic resonance (MR) imaging. In these patients, the T2-weighted images revealed a distinct appearance consisting of marked and discrete hyperintensity at the location of the intravertebral cleft. T1-weighted images were hypointense in this region. Recognition of this pattern is important in the MR imaging evaluation of compression fractures of the vertebral body so that confusion with malignancy or infection may be avoided, thereby obviating additional diagnostic studies.
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A 55-yr-old man presented with an atypical relapsing meningitis and was found to have intense unilateral adrenal uptake by 67Ga imaging. Computed tomography showed a 4-cm right adrenal mass which was hypointense on the T1-weighted images and mildly hyperintense on the T2-weighted images of a magnetic resonance (MR) scan. At surgery, a coincidental benign adrenocortical adenoma was found. Because 67Ga uptake is usually associated with inflammatory or malignant lesions and malignant adrenal lesions are hyperintense on T2-weighted MR images, these findings contributed to diagnostic uncertainty in this patient. Thus, a nonhyperfunctional adrenocortical adenoma may be associated with abnormal 67Ga uptake and atypical MR findings.
Granulocytic sarcoma is a rare, solid tumor composed of immature granulocytes usually found in association with systemic leukemia in younger patients. We present a case of granulocytic sarcoma occurring in an elderly female with no evidence of systemic leukemia. Computed tomography, MR (with and without Gd-DTPA), and angiography showed features commonly found in meningiomas.
PURPOSE: Our goal was to characterize the MR features of pathologically documented gliosarcoma and to determine if these features help differentiate gliosarcoma from other intracranial neoplasms. METHOD: MR studies of six patients with pathologically documented gliosarcoma were retrospectively analyzed. RESULTS: The tumors tended to be well defined lesions demonstrating either an inhomogeneous or cystic appearance with surrounding vasogenic edema. All tumors were characterized as primarily intraaxial but abutting a dural surface. On T2-weighted images, all tumors were of intermediate signal intensity with surrounding edema. The signal intensity of the tumor was similar to gray matter but was hypointense relative to other glial neoplasms. Postcontrast T1-weighted images showed intense tumor enhancement, often with a ring-like appearance. The isointense component on the T2-weighted images corresponded to this area of intense enhancement. CONCLUSION: Gliosarcoma exhibits some characteristic MR features. It should be included in the differential diagnosis of any tumor that appears to be intraaxial but abuts a dural surface and is much less hypointense on T2-weighted images than other glial neoplasms.
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We describe the clinical, MR, ultrasound, and pathologic findings of an intramedullary gliofibroma. This uncommon primitive tumor is thought to be of mixed glial and mesenchymal origin. Although the majority of tumors described to date have been histologically benign, clinical course has been quite variable. On MRI, the tumor we report was isointense to adjacent spinal cord on T1-weighted imaging and became hyperintense on proton and T2-weighted imaging. Enhancement with gadolinium diethylenetriamine pentaacetic acid was mild and slightly heterogeneous. Intraoperative ultrasound demonstrated widening of the lower thoracic cord. Echo pattern was generally similar to that of adjacent cord. The major differential diagnostic considerations include astrocytoma and ependymoma.
This case report describes clinical, surgical, MR, and pathologic findings of an intraventricular fibroma, a rare, benign mesenchymal neoplasm. Relatively isointense with normal brain parenchyma on T1-weighted images, the tumor exhibited hyperintense signal on T2-weighted pulse sequences and enhanced intensely and homogeneously after intravenous administration of gadopentetate dimeglumine. Choroid plexus papilloma/carcinoma, meningioma, ependymoma, and subependymal giant cell astrocytoma should be included in the differential diagnosis.