1、 Case report Xian central hospital Dang shanNew wordssomnolentia smnlenr 嗜睡 morphology m:rf:ldi 形态学paediatric pi:dtrk 儿科的 hydrocephalushadrsefls 脑积水 heterogeneous 成分混杂的 cauliflower 菜花 neuroepithelial 神经上皮的 prognosis 预后 infiltrate 浸润 渗透 Medical history 2-year-old male patient Somnolentia,decrease con
2、sciousness 3 hours A Ependymoma B Choroid plexus papilloma C Intraventricular meningioma D GlioblastomaWhat is your diagnosis?Pathological result Lateral ventricle glioblastoma Immunohistochemistry:GFAP+、S-100+、Vim+、Syn part+、Ki67 40%、Olig-2 few、CD99-/+、NeuN-CK-、EMA-Glioblastoma Incidence：Glioblasto
3、ma accounts for about 57%of all brain tumors in children Peak age：4555 years old less occur at age lower than 30-year-old Location:Supratentorial white matter most common,especially in frontal and temporal lobes.Morphology:Poorly-marginated,diffusely-infiltrating necrotic mass.Tumor typically across
4、es white matter tracts to involve contralateral hemisphere Prognosis:Poor,1year survival rate is only about 50%NECT Finding：Irregular isodense or hypodense mass with central hypodensity representing necrosis.Marked mass effect and surrouding edema,tumor infiltration，hemorrage not uncommon，calcificat
5、ion rare CECT Finding：95%have stong,heterogeneous,irregular rim-enhancement T1WI irregular isotense,hypointense white matter mass T2WI heterogeneous,hypointense mass with adjacent tumor infiltration and edema DWI no typically diffusion restriction necrosis,cysts,hemorrage may be seenMR FindingEpendy
6、moma Peak age:before the age of 5 years old Location:about 8%occured in the lateral ventricle Morphology：typically heterogeneous mass,with areas of necrosis,calcification,cystic change and frequent hemorrhage MR Finding：T1WI isointense to hypointense relative to white matter T2WI hyperintense to whi
7、te matter T1C+(Gd)enhancement present but heterogeneous DWI diffusion restrict may be seen in solid components CT Ependymoma MR Ependymoma An uncommon,benign neuroepithelial intraventricular tumour which can occur in both the paediatric and adult.lobulated or cauliflower-like masses hydrocephalus co
8、mmon CT iso-or somewhat hyperdense，homogeneous enhancement T1WI typically isointense or somewhat hypointense T2WI iso to hyperintense T1 C+(Gd)marked enhancement,tends to be homogenous Choroid plexus papilloma T2WI T1WI T1C+Choroid plexus papilloma Intraventricular meningioma Location:80%trigone of
9、lateral ventricle,15%the third ventricle,5%the fourth ventricle CT 60%slightly hyperdense to normal brain,20-30%have some calcification,72%brightly and homogenously contrast enhance,less frequent in malignant or cystic variants T1WI isointense or somewhat hypointense compared to grey matter T2WI isointense,hyperintense or hypointense compared to grey matter T1 C+(Gd)usually homogenous enhancementT1WI Intraventricular meningioma T2WI T1+C Thank you!
