The principles of echo-shifting with a train of observations (PRESTO) magnetic resonance (MR) imaging technique employs an MR sequence that sensitively detects susceptibility changes in the brain. The effectiveness of PRESTO MR imaging was examined for distinguishing between cerebellopontine angle (CPA) schwannomas and meningiomas in 24 patients with CPA tumors, 12 with vestibular schwannomas, and 12 with meningiomas. Histopathological study of surgical specimens showed that 11 of the 12 schwannomas contained hemosiderin deposits and all had microhemorrhages. One meningioma contained hemosiderin deposits and two involved microhemorrhages. Abnormal vessel proliferation, and dilated and thrombosed vessels were observed in all schwannomas and in 4 meningiomas. In addition to MR imaging with all basic sequences, PRESTO MR imaging and computed tomography were performed. PRESTO imaging showed significantly more schwannomas (n = 12) than meningiomas (n = 2) exhibited intratumoral spotty signal voids which were isointense to air in the mastoid air cells (p º 0.001). These spotty signal voids were significantly associated with histopathologically demonstrated hemosiderin deposits (p º 0.001), microhemorrhages (p º 0.01), and abnormal vessels (p º 0.04). The visualization of spotty signal voids on PRESTO images is useful to distinguish schwannomas from meningiomas.
Isolated pulmonary Langerhans cell histiocytosis (LCH) in adults is known to regress spontaneously after smoking cessation alone, but little is known about whether this rationale could also apply in cases of multisystem pulmonary LCH. In particular, pediatric patients with multisystem LCH including involvement in "risk organs" such as lungs often benefit from systemic chemotherapy. Here, we present a 37-year-old man with spontaneous regression of pulmonary lesions in multisystem LCH, achieved solely by smoking reduction following local treatment of bone lesions.
We report a case of secretory meningioma in a 64 − year − old woman who presented with depression and abnor − mal behavior . MRI demonstrated a well − enhanced tumor in the left middle fossa . The tumor was 3 cm in diameter and accompanied by remarkable brain edema in the left temporal Iobe . Caエotid angiograms showed multiple aneu − rysms of the bilateral internal carotid arteries . Through a left frontotemporal craniotomy , total removal of the tumor and neck clipping of the aneurysm of the left internal carotid artery were performed , After surgery , the patient 「 s symtoms improved and the edema disappeared . The tumor cells had many eosinophilic pseudopsammoma bodies . On immunohistochemistry , the tumor was positive fbr CEA and EMA and diagnosed as secretory meningioma . Tumor cells were also positive for VEGE which was possibly related to the severe brain edema in this case . Clinical and histopathological features of secretory meningioma are discussed ,
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