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Glioblastoma, demyelination

Leomar Y Ballester, Zain Boghani, David S Baskin, Gavin W Britz, Randall Olsen, Gregory N Fuller, Suzanne Z Powell, Matthew D Cykowski
Astrocytes with multiple micronuclei ("Creutzfeldt cells") in a brain biopsy are classically associated with demyelinating disease. However, glioblastoma may also have prominent Creutzfeldt astrocytes, along with granular mitoses. Therefore, Creutzfeldt cells may raise the diagnostic dilemma of high-grade glioma vs tumefactive demyelination. While cases of glioblastoma (GBM) with Creutzfeldt astrocytes have been reported, their clinicopathologic spectrum and genetic features are not understood. Studies have proposed that micronuclei in Creutzfeldt cells are a consequence of DNA damage, or may be susceptible to DNA damage and chromothripsis, but their biology in the context of glioblastoma remains unclear...
March 6, 2018: Brain Pathology
Zain Boghani, William J Steele, Matthew D Cykowski, Leomar Y Ballester, Gavin Britz
Differentiating demyelinating conditions from neoplastic conditions can pose a significant challenge. There are a number of reports in the literature of large ring-enhancing, space-occupying lesions that were initially considered neoplastic or infectious but, on further review, were deemed demyelinating. Creutzfeldt-Peters cells (CPC) are reactive astrocytes with fragmented nuclear inclusions that are routinely seen in multiple sclerosis (MS) and generally exclude the diagnosis of glioblastoma (GB). The patient is a 78-year-old man with a history of prostate cancer, which was treated with radiation therapy, who presented with altered mental status...
October 5, 2017: Curēus
Jian-Bo Wen, Wei-Yuan Huang, Wei-Xing-Zi Xu, Gang Wu, Dao-Ying Geng, Bo Yin
OBJECTIVE: Our purpose was to evaluate the diagnostic performance of diffusion-weighted imaging, the relative minimum apparent diffusion coefficient (rADCmin) in differentiating primary central nervous system lymphomas (PCNSLs) from glioblastomas (GBMs) and inflammatory demyelinating pseudotumors (IDPs). MATERIALS AND METHODS: Magnetic resonance images were reviewed retrospectively in 82 patients including 39 PCNSLs, 35 GBMs, and 8 IDPs. Regions of interest were drawn around the tumor on contrast-enhanced axial images; these images were transferred onto coregistered ADC maps to obtain the ADCmin, and the normalized ADCmin ratios (rADCmin) were calculated using the formula rADCmin = ADCmin of the lesion / ADCmin of the normal white matter...
November 2017: Journal of Computer Assisted Tomography
Merritt D Kinon, Aleka Scoco, Joaquim M Farinhas, Andrew Kobets, Karen M Weidenheim, Reza Yassari, Patrick A Lasala, Jerome Graber
BACKGROUND: Intracerebral ring enhancing lesions can be the presentation of a variety of pathologies, including neoplasia, inflammation, and autoimmune demyelination. Use of a precise diagnostic algorithm is imperative in correctly treating these lesions and minimizing potential adverse treatment effects. CASE DESCRIPTION: A 55-year-old patient presented to the hospital with complaints of a post-concussive syndrome and a non-focal neurologic exam. Imaging revealed a lesion with an open ring enhancement pattern, minimal surrounding vasogenic edema, and minimal mass effect...
2017: Surgical Neurology International
Rajeev Kumar Verma, Roland Wiest, Cäcilia Locher, Mirjam Rachel Heldner, Phillip Schucht, Andreas Raabe, Jan Gralla, Christian Philipp Kamm, Johannes Slotboom, Frauke Kellner-Weldon
PURPOSE: MR-imaging hallmarks of glioblastoma (GB), cerebral lymphoma (CL), and demyelinating lesions are gadolinium (Gd) uptake due to blood-brain barrier disruption. Thus, initial diagnosis may be difficult based on conventional Gd-enhanced MRI alone. Here, the added value of a dynamic texture parameter analysis (DTPA) in the differentiation between these three entities is examined. DTPA is an in-house software tool that incorporates the analysis of quantitative texture parameters extracted from dynamic susceptibility contrast-enhanced (DSCE) images...
August 2017: Medical Physics
Kirill A Lyapichev, Amade Bregy, Adrienne Cassel, Chelsea Handfield, Jose Velazquez-Vega, Matthew D Kay, Gregory Basil, Ricardo J Komotar
BACKGROUND: Malignant optic and chiasmatic gliomas are extremely rare, and are classified pathologically as anaplastic astrocytoma or glioblastoma multiforme (GBM). Approximately 40 cases of optic GBM in adults have been reported in the literature, and only five of them were described to originate from the optic chiasm. CASE DESCRIPTION: An 82-year-old male patient with a past medical history of diabetes mellitus type 2, melanoma, and bladder cancer presented with gradual vision loss of the left eye in a period of 1 month...
2016: Surgical Neurology International
Kirti Gupta, Sahil Mehta, Chirag K Ahuja, Pravin Salunke, Navneet Sharma
Tumefactive demyelinating (TD) lesions are extremely challenging lesions to diagnose during their histopathological examination and are often misdiagnosed as tumors. On the contrary, a glioblastoma multiforme is rarely misdiagnosed as a TD unless the two coexist. We present a case of a 60-year old man who was diagnosed as having tumefactive demyelination on a stereotactic biopsy. At autopsy, however, the lesion revealed a grade IV glioblastoma. The myelin loss along the periphery of the lesion was erroneously interpreted as TD during the histopathological examination...
July 2016: Neurology India
Jiri Polivka, Jiri Polivka, Kristyna Krakorova, Marek Peterka, Ondrej Topolcan
Neurology is one of the typical disciplines where personalized medicine has been recently becoming an important part of clinical practice. In this article, the brief overview and a number of examples of the use of biomarkers and personalized medicine in neurology are described. The various issues in neurology are described in relation to the personalized medicine and diagnostic, prognostic as well as predictive blood and cerebrospinal fluid biomarkers. Such neurological domains discussed in this work are neuro-oncology and primary brain tumors glioblastoma and oligodendroglioma, cerebrovascular diseases focusing on stroke, neurodegenerative disorders especially Alzheimer's and Parkinson's diseases and demyelinating diseases such as multiple sclerosis...
2016: EPMA Journal
Michael Fiechter, Ekkehard Hewer, Urspeter Knecht, Roland Wiest, Jürgen Beck, Andreas Raabe, Markus F Oertel
INTRODUCTION: Anaplastic pilocytic astrocytoma (APA) is an exceptionally rare type of high-grade glioma in adults. Establishing histopathological diagnosis is challenging and its clinical and radiological appearance insidious. By this case series and first literature review we investigated the various clinical, neuroradiological, and histopathological features of APA in adults. METHODS: An in hospital screening of the database from the Institute of Pathology was conducted to identify cases of APA...
August 2016: Clinical Neurology and Neurosurgery
Ilya Lekht, Noah Brauner, Joshua Bakhsheshian, Ki-Eun Chang, Mittul Gulati, Mark S Shiroishi, Edward G Grant, Eisha Christian, Gabriel Zada
OBJECTIVE: Intraoperative contrast-enhanced ultrasound (iCEUS) offers dynamic imaging and provides functional data in real time. However, no standardized protocols or validated quantitative data exist to guide its routine use in neurosurgery. The authors aimed to provide further clinical data on the versatile application of iCEUS through a technical note and illustrative case series. METHODS: Five patients undergoing craniotomies for suspected tumors were included...
March 2016: Neurosurgical Focus
Makoto Ideguchi, Koji Kajiwara, Hisaharu Goto, Kazutaka Sugimoto, Sadahiro Nomura, Eiji Ikeda, Michiyasu Suzuki
Magnetic resonance imaging (MRI) is an important diagnostic tool for glioblastoma, with almost all cases showing characteristic imaging findings such as a heterogeneous-ring enhanced pattern associated with significant edema. However, MRI findings for early-stage glioblastoma are less clear. In this study, a retrospective review of MRI findings in five patients showed slight T2WI signal changes on initial scans that developed into typical imaging findings of a ring-like or heterogeneously enhanced bulky tumor within 6 months...
June 2015: Journal of Neuro-oncology
Gema Elvira, Isabel García, Juan Gallo, Marina Benito, Paula Montesinos, Esther Holgado-Martin, Angel Ayuso-Sacido, Soledad Penadés, Manuel Desco, Augusto Silva, Jose A Garcia-Sanz
Neuroblasts represent the predominant migrating cell type in the adult mouse brain. There are, however, increasing evidences of migration of other neural precursors. This work aims at identifying in vivo endogenous early neural precursors, different from neuroblasts, able to migrate in response to brain injuries. The monoclonal antibody Nilo1, which unequivocally identifies type B astrocytes and embryonic radial glia, was coupled to magnetic glyconanoparticles (mGNPs). Here we show that Nilo1-mGNPs in combination with magnetic resonance imaging in living mice allowed the in vivo identification of endogenous type B astrocytes at their niche, as well as their migration to the lesion site in response to glioblastoma, demyelination, cryolesion or mechanical injuries...
January 2015: Stem Cell Research
Erin M McConnell, Matthew R Holahan, Maria C DeRosa
Oligonucleotide aptamers are short, synthetic, single-stranded DNA or RNA able to recognize and bind to a multitude of targets ranging from small molecules to cells. Aptamers have emerged as valuable tools for fundamental research, clinical diagnosis, and therapy. Due to their small size, strong target affinity, lack of immunogenicity, and ease of chemical modification, aptamers are an attractive alternative to other molecular recognition elements, such as antibodies. Although it is a challenging environment, the central nervous system and related molecular targets present an exciting potential area for aptamer research...
December 2014: Nucleic Acid Therapeutics
Peter Kar Han Lau, Gabriel Lee, Michael Bynevelt, Anna K Nowak
Primary spinal glioblastoma (GBM) is a rare spinal tumour and is considered to have poor prognosis. We describe a case of a 17-year-old adolescent boy with a cervical spine GBM presenting with neck pain and right upper limb weakness. Initial spinal MRI demonstrated a 4.5 cm lesion extending from C2 to C5 suspicious for demyelination. Despite high-dose corticosteroids, his weakness progressed resulting in quadriparesis. Subsequent laminectomy and biopsy confirmed spinal GBM. Shortly after surgery the patient continued to deteriorate and was essentially bedbound...
February 11, 2014: BMJ Case Reports
Joshua E Burda, Maja Radulovic, Hyesook Yoon, Isobel A Scarisbrick
Kallikrein 6 (KLK6) is a secreted serine protease preferentially expressed by oligodendroglia in CNS white matter. Elevated levels of KLK6 occur in actively demyelinating multiple sclerosis (MS) lesions and in cases of spinal cord injury (SCI), stroke, and glioblastoma. Taken with recent evidence establishing KLK6 as a CNS-endogenous activator of protease-activated receptors (PARs), we hypothesized that KLK6 activates a subset of PARs to regulate oligodendrocyte physiology and potentially pathophysiology. Here, primary oligodendrocyte cultures derived from wild type or PAR1-deficient mice and the murine oligodendrocyte cell line, Oli-neu, were used to demonstrate that Klk6 (rodent form) mediates loss of oligodendrocyte processes and impedes morphological differentiation of oligodendrocyte progenitor cells (OPCs) in a PAR1-dependent fashion...
September 2013: Glia
Malgorzata Sielska, Piotr Przanowski, Bartosz Wylot, Konrad Gabrusiewicz, Marta Maleszewska, Magdalena Kijewska, Malgorzata Zawadzka, Joanna Kucharska, Katyayni Vinnakota, Helmut Kettenmann, Katarzyna Kotulska, Wieslawa Grajkowska, Bozena Kaminska
Gliomas attract brain-resident (microglia) and peripheral macrophages and reprogram these cells into immunosuppressive, pro-invasive cells. M-CSF (macrophage colony-stimulating factor, encoded by the CSF1 gene) has been implicated in the control of recruitment and polarization of macrophages in several cancers. We found that murine GL261 glioma cells overexpress GM-CSF (granulocyte-macrophage colony-stimulating factor encoded by the CSF2 gene) but not M-CSF when compared to normal astrocytes. Knockdown of GM-CSF in GL261 glioma cells strongly reduced microglia-dependent invasion in organotypical brain slices and growth of intracranial gliomas and extended animal survival...
July 2013: Journal of Pathology
Mark Lyons
The differential diagnosis of multiple ring-enhancing intraaxial lesions includes neoplastic, infectious, inflammatory, demyelinating and vascular lesions. We report a case of a 41-year-old man who presented with a brief history of left lower extremity weakness and sensory loss. Magnetic resonance imaging demonstrated multiple ring-enhancing lesions in the right frontal and parietal lobes. Neuroradiology interpretation was felt to be unlikely for a neoplastic process. The patient underwent stereotactic brain biopsy, which was diagnostic for glioblastoma multiforme...
2013: Turkish Neurosurgery
Ilker Kudret Sariyer, Nana Merabova, Prem Kumer Patel, Tijana Knezevic, Alessandra Rosati, Maria C Turco, Kamel Khalili
JC virus, JCV, is a human neurotropic polyomavirus whose replication in glial cells causes the fatal demyelinating disease progressive multifocal leukoencephalopathy (PML). In addition, JCV possesses oncogenic activity and expression of its transforming protein, large T-antigen (T-Ag), in several experimental animals induces tumors of neural origin. Further, the presence of JCV DNA and T-Ag have been repeatedly observed in several human malignant tissues including primitive neuroectodermal tumors and glioblastomas...
2012: PloS One
Koen Mertens, Julie Bolcaen, Hamphrey Ham, Karel Deblaere, Caroline Van den Broecke, Tom Boterberg, Filip De Vos, Ingeborg Goethals
PURPOSE: To determine the optimal timing for imaging brain tumours and other brain lesions with 18F-labelled fluoromethylcholine (18F-FCho) PET. MATERIALS AND METHODS: Dynamic PET imaging with 18F-FCho (acquisition time of 28 min) was performed in 24 patients with space-occupying lesions in the brain. On the coregistered PET and MRI, lesion-to-normal tissue uptake ratios (LNRs) were calculated. Time-activity curves (TACs) were generated on the basis of the LNRs...
September 2012: Nuclear Medicine Communications
Koen Mertens, Hamphrey Ham, Karel Deblaere, Jean-Pierre Okito Kalala, Caroline Van den Broecke, Dominique Slaets, Filip De Vos, Ingeborg Goethals
PURPOSE: To evaluate the distribution of 18F-labelled fluoromethylcholine (FCho) in normal structures and tumors of the head region using positron emission tomography (PET) and magnetic resonance imaging. MATERIALS AND METHODS: We retrospectively reviewed the positron emission tomography, magnetic resonance imaging, and the coregistered images obtained in 17 patients with suspected high-grade gliomas. The accumulation of 18F-FCho in the normal structures and in brain lesions was visually and semiquantitatively assessed...
August 2012: Clinical Nuclear Medicine
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