0:00

Here's a patient with a expand extensive expansile,

0:05

T two hyperintense lesion involving the right temporal pole,

0:08

the right insula, um, the right inferior frontal gyrus,

0:13

the right inferior parietal lole.

0:15

And there's even extension across the body

0:18

of the corpus callosum to the left frontal lobe,

0:22

and there's facilitated diffusion within it.

0:25

There's no abnormal post contrast enhancement.

0:28

So this is a diffuse astrocytoma is confirmed,

0:33

but very different than those other two.

0:36

This is not discretely marginated.

0:38

This is not d discreetly resectable.

0:42

Um, again, previously referred to

0:43

as a fibrillary astrocytoma for this one also.

0:46

Um, and this in my mind is more of a,

0:50

a gliosis cerebral pattern of spread

0:53

of a diffuse astrocytoma.

0:55

The reason I say it like that is

0:56

because a biopsy would never sh show.

1:01

Oh, this is gliosis cerebra.

1:03

Gliosis cerebra is a pattern of involvement, um, that,

1:09

um, we now know can be achieved

1:11

by different histologic types of tumor.

1:14

Um, just like in pulmonary imaging,

1:18

I remember there's no biopsy that shows IPF.

1:21

You get a UIP, um,

1:23

usual interstitial pneumonia biopsy result,

1:27

and then the macroscopic distribution would be,

1:30

can then be suggestive of an IPF diagnosis.

1:34

So similarly, there's a difference between the histologic

1:38

diagnosis in a given spot

1:40

and the pattern of spread for the disease process.

Case: Diffuse Astrocytoma With Gliomatosis Cerebri Pattern of Spread

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0:00

Here's a patient with a expand extensive expansile,

0:05

T two hyperintense lesion involving the right temporal pole,

0:08

the right insula, um, the right inferior frontal gyrus,

0:13

the right inferior parietal lole.

0:15

And there's even extension across the body

0:18

of the corpus callosum to the left frontal lobe,

0:22

and there's facilitated diffusion within it.

0:25

There's no abnormal post contrast enhancement.

0:28

So this is a diffuse astrocytoma is confirmed,

0:33

but very different than those other two.

0:36

This is not discretely marginated.

0:38

This is not d discreetly resectable.

0:42

Um, again, previously referred to

0:43

as a fibrillary astrocytoma for this one also.

0:46

Um, and this in my mind is more of a,

0:50

a gliosis cerebral pattern of spread

0:53

of a diffuse astrocytoma.

0:55

The reason I say it like that is

0:56

because a biopsy would never sh show.

1:01

Oh, this is gliosis cerebra.

1:03

Gliosis cerebra is a pattern of involvement, um, that,

1:09

um, we now know can be achieved

1:11

by different histologic types of tumor.

1:14

Um, just like in pulmonary imaging,

1:18

I remember there's no biopsy that shows IPF.

1:21

You get a UIP, um,

1:23

usual interstitial pneumonia biopsy result,

1:27

and then the macroscopic distribution would be,

1:30

can then be suggestive of an IPF diagnosis.

1:34

So similarly, there's a difference between the histologic

1:38

diagnosis in a given spot

1:40

and the pattern of spread for the disease process.

Report

Faculty

Asim F Choudhri, MD

Chief, Pediatric Neuroradiology

Le Bonheur Children's Hospital

Lesson

Introduction

Lesson

Meningiomas

Lesson

Non-glial Tumors

Lesson

2021 WHO CNS Tumor Classification

Lesson

Gliomas

Lesson

Pediatric Brain Tumor Cases

Case: Diffuse Astrocytoma With Gliomatosis Cerebri Pattern of Spread