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The New World Health Organization Classification of Central Nervous System Tumors: What Can the Neuroradiologist Really Say?

A.G. Osborn, K.L. Salzman, M.M. Thurnher, J.H. Rees and M. Castillo
American Journal of Neuroradiology May 2012, 33 (5) 795-802; DOI: https://doi.org/10.3174/ajnr.A2583
A.G. Osborn
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K.L. Salzman
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M.M. Thurnher
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J.H. Rees
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M. Castillo
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    Fig 1.

    A young adult with intractable seizures. A, Axial fluid-attenuated inversion recovery image shows a hyperintense cortically based mass with subcortical stalk-like extension toward the ventricle (arrow). B, Axial T1C+ image shows an expanded gyrus with a hyperintense rim and hypointense center (arrow). Note subtle erosion of the inner calvaria. Angiocentric glioma was found at histologic examination.

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    Fig 2.

    A 20-month-old child with failure to thrive. A, Axial T2WI shows a massive inhomogeneously hyperintense suprasellar mass with extension into the left temporal lobe. B, Axial T1C+ image shows strong but heterogeneous enhancement. Pilomyxoid variant of pilocytic astrocytoma was documented at surgery. Case courtesy of R. Hewlett, MD.

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    Fig 3.

    Sagittal T1C+ image in an infant with hydrocephalus shows an intensely enhancing lobulated mass in the third and lateral ventricles. Histologic diagnosis was aCPP (WHO grade II).

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    Fig 4.

    A child with long-standing seizures. A, Sagittal T1WI shows a mixed cystic-solid mass. B, Axial T2WI shows that the nodule is inhomogeneously hyperintense. No enhancement was seen on contrast-enhanced images (not shown). Histologic diagnosis was PGNT.

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    Fig 5.

    A 21-year-old man with headaches. A, Axial T2* image shows a mixed cystic-solid fourth ventricular mass with fluid-fluid levels and hemorrhage. B, Postcontrast axial T1WI shows inhomogeneous enhancement. Histology proved RGNT of the fourth ventricle.

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    Fig 6.

    A 24-year-old man presented with seizures. A, Axial T2WI shows a bubbly-appearing mass in the left parahippocampal gyrus (arrow). B, T1C+ image shows no enhancement. Histologic examination disclosed extraventricular neurocytoma. Case courtesy of C. Glastonbury, MBBS.

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    Fig 7.

    A 66-year-old patient who presented with headache and neck stiffness. A, Axial T2WI shows a well-delineated mixed iso-/hyperintense lobulated mass in the pineal region (arrow). B, Sagittal postcontrast T1WI shows that the mass enhances intensely. Papillary tumor of the pineal region was documented at pathologic examination.

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    Fig 8.

    A 57-year-old woman who presented with Parinaud syndrome. A, Axial T2WI shows a large mixed hyperintense mass with focal invasion of the right thalamus (arrow). B, Axial T1WI after contrast administration shows that the mass enhances strongly but inhomogeneously. Preoperative diagnosis of PPTID was confirmed at histologic examination.

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    Fig 9.

    Two different cases of medulloblastoma with extensive nodularity are illustrated. A, Coronal T1C+ image in a 10-month-old infant shows strong enhancement of grapelike nodules in a huge posterior fossa mass. MBEN was diagnosed at pathology. Case courtesy of B. Jones, MD. B, A child with headaches and papilledema has a grossly nodular enhancing mass in the right cerebellum. Histologic diagnosis was MBEN.

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    Fig 10.

    A 5-year-old child with surgically proved anaplastic MB. A, Axial T2WI shows a large mostly isointense mass in the left cerebellar hemisphere. B, T1C+ image the mass enhances intensely but somewhat heterogeneously. Case courtesy of S. Blaser, MD.

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    Fig 11.

    Newly recognized sellar region tumors are illustrated. A, Sagittal T1C+ image in a 22-year-old woman with hypopituitarism shows a well-delineated strongly enhancing infundibular mass that is clearly separate from the pituitary gland below. Pituicytoma. B, Sagittal T1C+ scan in a 69-year-old patient with headaches and bitemporal hemianopsia has an enhancing sellar/suprasellar mass that has enlarged the sella. Preoperative diagnosis was macroadenoma. Histologic diagnosis was SCO. Case courtesy of P. Hildenbrand, MD.

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American Journal of Neuroradiology: 33 (5)
American Journal of Neuroradiology
Vol. 33, Issue 5
1 May 2012
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A.G. Osborn, K.L. Salzman, M.M. Thurnher, J.H. Rees, M. Castillo
The New World Health Organization Classification of Central Nervous System Tumors: What Can the Neuroradiologist Really Say?
American Journal of Neuroradiology May 2012, 33 (5) 795-802; DOI: 10.3174/ajnr.A2583

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The New World Health Organization Classification of Central Nervous System Tumors: What Can the Neuroradiologist Really Say?
A.G. Osborn, K.L. Salzman, M.M. Thurnher, J.H. Rees, M. Castillo
American Journal of Neuroradiology May 2012, 33 (5) 795-802; DOI: 10.3174/ajnr.A2583
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