Diffuse Cerebrospinal Gliomatosis

Abstract

A 65-year-old male was admitted with memory and gait disturbance. A computed tomography (CT) scan showed bilateral, diffuse, low-density areas with two round, slightly enhanced masses. T1-weighted magnetic resonance image revealed a low-intensity area in the left paraventricular region, which converted to increased signal intensity, extending to the right paraventricular region through the splenium, on T2-weighted images. The tumor was diagnosed as glioblastoma multiforme after needle biopsy and treated by irradiation and chemotherapy. Seven months after admission, a CT scan revealed subependymal infiltration of the tumor with spotty calcification. He died of respiratory complications 11 months after the onset of symptoms. The autopsy showed brain swelling with flattened gyri. Horizontal sections of the brain showed diffuse enlargement of the white matter and basal ganglia with scattered hemorrhage and necrosis. Microscopically, the lesion was far more extensive and diffuse than was suspected from gross examination. Wide glial tumor cell infiltration was observed in the cerebral hemispheres, basal ganglia, brainstem, cerebellum, and even the cervical spinal cord with minimum destruction of the pre-existing architecture. Calcification was found around the thrombosed vessels and necrotic lesions. The clinical diagnosis and histological features of gliomatosis cerebri are discussed with reference to reported cases.

Oligodendroglial Gliomatosis cerebri in a Poodle

“…In the present case, neoplastic cells infiltrated cerebrum, brainstem and cerebellum but no changes were observed in the spinal cord. GC with spinal cord invasion has been occasionally reported in human medicine 19,20 as well as in one out of the six canine cases studied by Porter et al 3 Besides, in human cases of GC a typical finding is the widening of the white matter tracts (particularly the corpus callosum and posterior limb of the internal capsule) 21 . In the present case, an enlargement of the affected hemisphere was observed.…”

A Serial CT Scan and MRI Verification of Diffuse Cerebrospinal Gliomatosis: A Case Report with Stereotactic Diagnosis and Radiological Confirmation

“…Nevin [ 16], Moore [ 17], Kawano et al [20], Yamamoto et al [28], Schmidbauer et al [31], Sarhaddi et al [34] and Ferraro et al [50] reported cases with spinal involvement. Sarhaddi et al [34] reported a case of spinal astrogliosis without neoplasia.…”

‘What's in a name?’

“…Kawano et al, 18 Yamamoto et al, 19 Schmidbauer et al, 20 Ferraro et al, 21 Finally, inconclusive symptoms, noninformatory laboratory data, nonspecific changes on CT, and the usual isointense to hypointense images on T1-and diffuse high signal intensity on T2-weighted images on MRI -in at least two, but often three lobes of the brain with extension into the…”