A distinctive glioneuronal tumor of the adult cerebrum with neuropil-like (including "rosetted") islands: report of 4 cases.

摘要: Four examples of a novel glioneuronal neoplasm are presented. All tumors affected adults (including two males and females aged 25-40 years) as supratentorial, cerebral hemispheric masses with associated seizure activity and, in one case, symptoms raised intracranial pressure progressive hemiparesis. CT scans cases revealed hypodense without calcification. MRI at presentation demonstrated, all cases, solid T1-hypointense T2-hyperintense mass effect instance but no edema or contrast enhancement. Only was relatively circumscribed on neuroradiologic study. were infiltrative their histologic growth pattern predominantly glial appearance, being composed mainly fibrillary, gemistocytic, protoplasmic astroglial elements WHO grade II to III. Their distinguishing feature content sharply delimited, neuropil-like islands intense synaptophysin reactivity inhabited rimmed rosetted fashion by cells demonstrating strong nuclear immunolabeling for the neuronal antigens NeuN Hu. These included small, oligodendrocyte-like ("neurocytic") well larger, more pleomorphic forms. Two contained, addition, well-differentiated neurons medium ganglion-cell size. Proliferative observed principally within compartment; contained mitotic figures exhibited elevated MIB-1 indices (6.8% 8.2%). One latter progressed proved fatal 30 months following subtotal resection radiotherapy. The three other patients alive intervals 14 83 months, tumor-free extensive disease appearance enhancement MRI. This tumor variant may pursue an unfavorable clinical course.