In herpes simplex encephalitis (HSE), the authors noted an evident dissociation between the 99mTc-ethyl cysteinate dimer (ECD) and 99mTc-d,l-hexamethyl-propylene-amine oxime (HMPAO) single photon emission computed tomographies (SPECTs). The patient was a 5-year-old boy with diffuse type of pontine glioma, which was treated with hyperfractionated radiotherapy. Two weeks after the completion of radiation therapy, a lesion suggesting that of HSE was noted in the right fronto-temporal region on magnetic resonance images. 99mTc-HMPAO SPECT showed an increased accumulation of the tracer in this lesion. On the 99mTc-ECD dynamic SPECT, an exaggerated accumulation of the tracer was noted within 80 s of administration, followed by a rapid drop in the accumulation, resulting in a low accumulation in 10 min. It was assumed that this dissociation was due to the different mechanisms to trap HMPAO and ECD in the brain tissue.
The relationship between invasiveness and proliferative potential was studied in 31 cases of pituitary adenomas. The invasiveness was determined by histological examination of sellar floor dura resected during transsphenoidal surgery. The proliferative potential of adenoma specimens was examined im munohistochemically using monoclonal antibody (MIB-1). There were 11 adenomas with histological ly verified dural invasion out of 31 cases. These adenomas had a higher MIB-1-positive ratio than adenomas without dural invasion (p < 0.05). Pituitary adenomas with a high proliferative potential tend to be invasive.
A case of congenital cerebellar tumor is reported. The tumor is composed of a few incomplete tubular structures analogous to the neural tube, and of neuroblastic, mature ganglionic, astrocytic, ependymal and undetermined neuroepithelial cells. A tentative diagnosis of congenital cerebellar neuroepithelial tumor with multiple divergent differentiations is made: the histogenesis is discussed. From a histogenetic point of view this tumor is given the provisional name of matrix cell tumor.
The relationship between magnetic resonance (MR) imaging findings and histologically verified invasion of the cavernous sinus by tumor cells was studied in 26 patients treated surgically for pituitary adenoma. Dural invasion of the sellar floor by tumor cells was found in 10 cases (38%). All patients were classified according to MR imaging findings into three types. Type I showed a gadolinium-enhanced stripe medial to the carotid artery (5 patients), none of which showed dural invasion. Type II showed no enhanced stripe (17 patients), six of which showed dural invasion. Within this type, tumor size and dural invasion showed no correlation. Type III showed displacement or encasement of the carotid artery by the tumor with or without extracranial extension (4 patients), all of which showed massive infiltration of the tumor cells into the dura mater. This study shows that preoperative MR imaging can provide information for assessment of invasion into the cavernous sinus in patients with pituitary adenoma.
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