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From the Archives of the AFIP

Superficial Gliomas: Radiologic-Pathologic Correlation¹

¹ From the Departments of Radiologic Pathology (K.K.K.) and Neuropathology (J.M.H.), Armed Forces Institute of Pathology, Bldg 54, Rm M-121, 14th St at Alaska Ave, Washington, DC 20306-6000; and the Departments of Radiology and Nuclear Medicine (K.K.K.) and Pathology (J.M.H.), Uniformed Services University of the Health Sciences, Bethesda, Md. Received June 11, 2001; revision requested June 27 and received July 26; accepted July 30. Address correspondence to K.K.K. (e-mail: koeller@afip.osd.mil).

Glial neoplasms that are peripherally located and involve the cortical gray matter are noteworthy because of their predilection to serve as a seizure locus, their amenability to surgical resection, their generally favorable prognosis, and their characteristic imaging features, which facilitate diagnosis before surgery. The smaller lesions include ganglioglioma and dysembryoplastic neuroepithelial tumor. Gangliogliomas contain both neuronal and glial components and occur most commonly in the temporal lobe. Variant forms of gangliogliomas may occur and are related to the different compositions of the underlying cellular population. Gangliocytomas lack glial cells and are located both in the cerebral hemispheres and the cerebellum. Lhermitte-Duclos disease represents a specific type of cerebellar gangliocytoma with dysplastic features and is characterized by a laminar pattern at imaging. Dysembryoplastic neuroepithelial tumors occur predominantly in children and young adults with partial seizures and most commonly arise in the temporal lobe, frequently in combination with cortical dysplasia. Surrounding vasogenic edema is conspicuously absent in both gangliogliomas and dysembryoplastic neuroepithelial tumors. The larger masses in this group include desmoplastic infantile ganglioglioma and pleomorphic xanthoastrocytoma and tend to involve the leptomeninges and cortical territory. Both invoke an intense desmoplastic reaction, which appears as an enhancing soft-tissue component at imaging.

Index Terms: Brain neoplasms, 10.363 • Brain neoplasms, CT, 10.12112 • Brain neoplasms, diagnosis, 10.363 • Brain neoplasms, MR, 10.12141

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