DOI: 10.1148/rg.252045095
Supratentorial Ependymoma1
Koen Mermuys, MD,
Wino Jeuris, MD,
Piet K. Vanhoenacker, MD,
Lieven Van Hoe, MD, PhD and
Pierre D’Haenens, MD
1 From the Departments of Radiology (K.M., P.K.V., L.V.H., P.D.) and Pathology (W.J.), Onze Lieve Vrouw Hospital, Aalst, Belgium. Received April 29, 2004; revision requested June 2 and received July 6; accepted July 7. All authors have no financial relationships to disclose.
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Figure 1a. (a) Axial unenhanced CT scan of the brain shows a large (9.5 x 6 cm) space-occupying lesion in the left cerebral hemisphere (arrows) with mass effect and large internal calcifications. (b) Axial unenhanced CT scan of the brain (bone window) shows scalloping of the internal cortex of the parietal bone (arrows) and the calcifications in the tumor.
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Figure 1b. (a) Axial unenhanced CT scan of the brain shows a large (9.5 x 6 cm) space-occupying lesion in the left cerebral hemisphere (arrows) with mass effect and large internal calcifications. (b) Axial unenhanced CT scan of the brain (bone window) shows scalloping of the internal cortex of the parietal bone (arrows) and the calcifications in the tumor.
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Figure 2a. (a) Axial T1-weighted image shows that the tumor is iso- to hypointense. Arrows = hyperintense areas consistent with hemorrhage. (b) Axial T2-weighted image shows that the tumor is largely heterogeneous with hypointense areas representing calcifications (top arrow) and hyperintense areas consistent with necrosis (bottom arrow). (c) Axial FLAIR image shows that the tumor is moderately hyperintense with central areas of high signal intensity due to necrosis (arrows). (d, e) Coronal (d) and axial (e) gadolinium-enhanced T1-weighted images show moderate enhancement of the tumor with nonenhancing areas of necrosis (black arrows). White arrows = invasion of the overlying meninges and bone.
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Figure 2b. (a) Axial T1-weighted image shows that the tumor is iso- to hypointense. Arrows = hyperintense areas consistent with hemorrhage. (b) Axial T2-weighted image shows that the tumor is largely heterogeneous with hypointense areas representing calcifications (top arrow) and hyperintense areas consistent with necrosis (bottom arrow). (c) Axial FLAIR image shows that the tumor is moderately hyperintense with central areas of high signal intensity due to necrosis (arrows). (d, e) Coronal (d) and axial (e) gadolinium-enhanced T1-weighted images show moderate enhancement of the tumor with nonenhancing areas of necrosis (black arrows). White arrows = invasion of the overlying meninges and bone.
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Figure 2c. (a) Axial T1-weighted image shows that the tumor is iso- to hypointense. Arrows = hyperintense areas consistent with hemorrhage. (b) Axial T2-weighted image shows that the tumor is largely heterogeneous with hypointense areas representing calcifications (top arrow) and hyperintense areas consistent with necrosis (bottom arrow). (c) Axial FLAIR image shows that the tumor is moderately hyperintense with central areas of high signal intensity due to necrosis (arrows). (d, e) Coronal (d) and axial (e) gadolinium-enhanced T1-weighted images show moderate enhancement of the tumor with nonenhancing areas of necrosis (black arrows). White arrows = invasion of the overlying meninges and bone.
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Figure 2d. (a) Axial T1-weighted image shows that the tumor is iso- to hypointense. Arrows = hyperintense areas consistent with hemorrhage. (b) Axial T2-weighted image shows that the tumor is largely heterogeneous with hypointense areas representing calcifications (top arrow) and hyperintense areas consistent with necrosis (bottom arrow). (c) Axial FLAIR image shows that the tumor is moderately hyperintense with central areas of high signal intensity due to necrosis (arrows). (d, e) Coronal (d) and axial (e) gadolinium-enhanced T1-weighted images show moderate enhancement of the tumor with nonenhancing areas of necrosis (black arrows). White arrows = invasion of the overlying meninges and bone.
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Figure 2e. (a) Axial T1-weighted image shows that the tumor is iso- to hypointense. Arrows = hyperintense areas consistent with hemorrhage. (b) Axial T2-weighted image shows that the tumor is largely heterogeneous with hypointense areas representing calcifications (top arrow) and hyperintense areas consistent with necrosis (bottom arrow). (c) Axial FLAIR image shows that the tumor is moderately hyperintense with central areas of high signal intensity due to necrosis (arrows). (d, e) Coronal (d) and axial (e) gadolinium-enhanced T1-weighted images show moderate enhancement of the tumor with nonenhancing areas of necrosis (black arrows). White arrows = invasion of the overlying meninges and bone.
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Figure 3. Photograph of the resected specimen shows that the tumor is lobulated with two fairly distinct areas: a soft, pink anterior component (left) and a posterior component (right) that clearly has areas of necrosis (top arrow) and hemorrhage (bottom arrow).
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Figure 4a. (a) Low-power photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows that the tumor is moderately cellular with necrotic and fibrotic transformed areas (white arrows) and numerous dystrophic calcifications (black arrows). (b) High-power photomicrograph (original magnification, x200; hematoxylin-eosin stain) shows that the tumor is moderately cellular and highly vascularized with numerous branching thin-walled vessels (arrowhead). Some of the vessels are typically surrounded by a fibrillar and acellular zone (pseudorosettes) (arrows).
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Figure 4b. (a) Low-power photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows that the tumor is moderately cellular with necrotic and fibrotic transformed areas (white arrows) and numerous dystrophic calcifications (black arrows). (b) High-power photomicrograph (original magnification, x200; hematoxylin-eosin stain) shows that the tumor is moderately cellular and highly vascularized with numerous branching thin-walled vessels (arrowhead). Some of the vessels are typically surrounded by a fibrillar and acellular zone (pseudorosettes) (arrows).
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Copyright © 2005 by the Radiological Society of North America.
