Pathology-MRI correlations in diffuse low-grade epilepsy associated tumors

Al-Hajri, A., Al-Mughairi, S., Somani, A., An, S., Liu, J.Y.W., Miserocchi, A., McEvoy, A.W., Yousry, T., Hoskote, C. and Thom, M. 2017. Pathology-MRI correlations in diffuse low-grade epilepsy associated tumors. Journal of Neuropathology and Experimental Neurology. 76 (12), pp. 1023-1033. https://doi.org/10.1093/jnen/nlx090

TitlePathology-MRI correlations in diffuse low-grade epilepsy associated tumors
TypeJournal article
AuthorsAl-Hajri, A., Al-Mughairi, S., Somani, A., An, S., Liu, J.Y.W., Miserocchi, A., McEvoy, A.W., Yousry, T., Hoskote, C. and Thom, M.
Abstract

It is recognized that IDH mutation negative, low-grade epilepsy associated tumors (LEAT) can show diffuse growth patterns and lack the diagnostic hallmarks of either classical dysembryoplastic neuroepithelial tumors (DNT) or typical ganglioglioma. “Nonspecific or diffuse DNT” and more recently “polymorphous low-grade neuroepithelial tumor of the young” have been terms used for these entities. There are few reports on the MRI recognition of these diffuse glioneuronal tumors (dGNT), which is important in planning the extent of surgical resection. In 27 LEATs T1, T2, FLAIR, and postcontrast T1 MRI were evaluated and the pathology reviewed, including immunostaining for NeuN, CD34, MAP2, and IDH1. Each case was then independently classified by pathology or MRI as simple DNT, complex DNT, or dGNT. There was agreement in 23/27 (85%; Kappa score 0.62; p < 0.01). In 4 cases, there was discrepancy in the diagnosis of simple versus complex DNT but 100% agreement achieved for dGNT. DNT showed significantly more expansion of the cortex, cystic change and ventricle extension than dGNT. dGNT showed significantly more subcortical T2w hyperintensity and focal cortical atrophy which correlated on pathology with CD34 expression, cortical neuronal loss and white matter rarefaction. There was no distinct cortical dysplasia component identified by MRI or pathology in any case. This study highlights that dGNT can be reliably discriminated on MRI from DNT.

JournalJournal of Neuropathology and Experimental Neurology
Journal citation76 (12), pp. 1023-1033
ISSN0022-3069
1554-6578
Year2017
PublisherOxford University Press
Publisher's version
License
CC BY 4.0
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1093/jnen/nlx090
Publication dates
PublishedDec 2017

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