Abstract
Correlative study of computed tomography (CT) and pathologic findings was performed in eight cases of pontine glioma. All patients except one had chemotherapy and radiotherapy, with no surgical intervention. On initial CT scans, all patients had hypodense lesions in part or the whole of the pons, and there was evidence of mass effect. Four of eight cases showed contrast enhancement. After chemotherapy and radiotherapy, swelling of the pons and the width of the hypodense areas decreased. The hypodense areas sometimes became isodense in correlation with clinical amelioration. After several months of remission in responding cases, ring-enhanced lesions reappeared at the primary site, together with recurrent neurological signs. Pathological study postmortem was focused on the histological counterparts of the CT findings of central and perifocal hypodense areas and contrast enhancement. In six of seven treated cases, the central hypodense area surrounded by ring enhancement was shown to be coagulation necrosis. Higher cellularity and hypervascularity with glomeruluslike structures of small vessels were generally observed in enhanced areas. The areas diffusely infiltrated by tumor cells, but not enhanced in CT scans, had few abnormal vessels. Tumor cells were seen not only in hypodense areas around the enhanced portion but also in areas far beyond the enhanced portion. Exophytic expansion of tumor was observed in two cases on postmortem examination. One of these was detected by CT scans before death.
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References
Brem S (1976) The role of vascular proliferation in the growth of brain tumors. Clin Neurosurg 23:440–453
Brismar J, Roberson GH, Davis KR (1976) Radiation necrosis of the brain. Neuroradiological considerations with computed tomography. Neuroradiology 12:109–113
Burger PC, Dubois PJ, Schold SC Jr, Smith KR Jr, Odom GL, Crafts DC, Giangaspero F (1983) Computerized tomographic and pathologic studies of the untreated, quiescent, and recurrent glioblastoma multiforme. J Neurosurg 58:159–169
Butler AR, Horii SC, Kricheff II, Shannon MB, Budzilovich GN (1978) Computed tomography in astrocytomas. A statistical analysis of the parameters of malignancy and the positive contrast-enhanced CT scan. Radiology 129:433–439
Gado MH, Phelps ME, Coleman RE (1975) An extravascular component of contrast enhancement in cranial computed tomography. II. Contrast enhancement and the blood-tissue barrier. Radiology 117:595–597
Hyman RA, Loring MF, Liebeskind AL, Naidich JB, Stein HL (1978) Computed tomographic evaluation of therapeutically induced changes in primary and secondary brain tumors. Neuroradiology 14:213–218
Lilja A, Bergström K, Spännare B, Yngve O (1981) Reliability of computed tomography in assessing histopathological features of malignant gliomas. J Comput Assist Tomogr 5:625–636
Matsui T (1979) Neuropathological studies of CT findings in glioblastoma multiforme. J Comput Assist Tomogr 3:566 (abstr)
Norman D, Enzmann DR, Levin VA, Wilson CB, Newton TH (1976) Computed tomography in the evaluation of malignant glioma before and after therapy. Radiology 121:85–88
Salcman M, Levin H, Rao K (1981) Value of sequential computed tomography in the multimodality treatment of glioblastoma multiforme. Neurosurgery 8:15–19
Selker RG, Mendelow H, Walker M, Sheptak PE, Phillips JG (1982) Pathological correlation of CT ring in recurrent, previously treated gliomas. Surg Neurol 17:251–254
Steinhoff H, Lanksch W, Kazner E, Grumme T, Meese W, Lange S, Aulich A, Schindler E, Wende S (1977) Computed tomography in the diagnosis and differential diagnosis of glioblastomas. Neuroradiology 14:193–200
Takeda N, Tanaka R, Yamazaki K (1980) Correlation of computed tomography with post-mortem histopathology of cerebral malignant glioma (in Japanese). Neurol Med Chir (Tokyo) 20:603–611
Tanaka R, Takeda N, Okada K, Ueki K (1979) Computerized tomography of coagulation necrosis of the brain and brain tumors. Surg Neurol 11:9–12
Tchang S, Scotti G, Terbrugge K, Melançon D, Bélanger G, Milner C, Ethier R (1975) Computerized tomography as a possible aid to histological grading of supratentorial gliomas. J Neurosurg 46:735–739
Tsuchida T (1974) A study of capillary ultrastructure of brain tumors in association with blood-brain barrier (in Japanese). Adv Neurol Sci (Toyko) 18:106–121
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Tsuchida, T., Shimbo, Y., Fukuda, M. et al. Computed tomographic and histopathological studies of pontine glioma. Child's Nerv Syst 1, 223–229 (1985). https://doi.org/10.1007/BF00270767
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DOI: https://doi.org/10.1007/BF00270767