Pleomorphic xanthoastrocytoma: magnetic resonance imaging findings in a series of cases with histopathological confirmation

Abstract

Pleomorphic xanthoastrocytoma (PXA) is a rare glioma. This paper aimed to analyze magnetic resonance imaging (MRI) characteristics in a series of patients diagnosed with PXA. We analyzed MRI findings in 9 patients with histopathologic diagnosis of PXA in our department over the last 12 years. The mean age of patients was 27.3 years. Cortical location was observed in all cases. The lesion imaging was solid-cystic in six cases. In eight cases, the solid component presented hypo or isointense on T1 and iso or hyperintense on T2. Contrast enhancement in the solid component was observed in eight cases. The observed imaging pattern of PXA was superficial location with leptomeningeal involvement, solid-cystic pattern and contrast enhancement in the solid component. We should consider that the association between PXA and other cortical tumors may occur, particularly, with gangliogliomas, which tend to be the main differential diagnosis in MRI.Key words: magnetic resonance imaging, central nervous system, astrocytoma. RESUMOXantoastrocitoma pleomórfico (PXA) é um glioma raro. Este estudo teve como objetivo analisar aspectos de imagem por ressonância magnética (RM) de uma série de pacientes com diagnóstico de PXA. Foram analisados exames de RM de 9 pacientes com diagnóstico histopatológico de PXA nos últimos 12 anos. A média de idade dos pacientes foi de 27,3 anos. Localização cortical foi observada em todos os casos. Padrão sólido-cístico foi observado em seis casos. Em oito casos, o componente sólido apresentou-se hipo ou isointenso em T1 e iso ou hiperintenso em T2. Foi observada captação de contraste na porção sólida em oito casos. O padrão de imagem observado do PXA foi de localização superficial com envolvimento leptomeníngeo, padrão sólido-cístico e captação de contraste pelo componente sólido. Devemos considerar que a associação entre PXA e outros tumores corticais pode ocorrer, particularmente, com ganglioglioma, que tende a ser o principal diagnóstico diferencial em RM.Palavras-Chave: imagem por ressonância magnética, sistema nervoso central, astrocitoma.

Clinical, histological and imaging aspects of pleomorphic xanthoastrocytomas: the key is in the name

“…Leptomeningeal dissemination is usually related to malignant features of PXAs, although this is not always the case 13 . Gonçalves et al 14 , in the present issue of Arquivos de Neuro-Psiquiatria, shed light on some interesting topics related to histology and imaging aspects of PXA, in agreement with the literature and also adding local flavor to the study of these tumors.…”

Pleomorphic Xanthoastrocytoma of Childhood: MR Imaging and Diffusion MR Imaging Features

“…[6][7][8][9] Although there are imaging reports of PXAs in children and adults, dedicated pediatric imaging studies are rare and diffusion MR imaging characteristics were not previously described. [10][11][12][13][14] In 1 of the earliest MR imaging reports, Lipper et al 12 described imaging findings of PXA in 7 patients, 3 of whom were children. Peripheral location of PXA in the cerebral hemispheres was emphasized in this report.…”

Parieto-temporal pleomorphic xanthoastrocytoma in a black African child

“…There may also be some cystic components on MRI. The use of MRI has been suggested to be more diagnostic in imaging than CT.[111213]…”