DOI: 10.1148/rg.256055137
Oligodendroglioma and Its Variants: Radiologic-Pathologic Correlation1
Kelly K. Koeller, CAPT, MC, USN and
Elisabeth J. Rushing, COL, MC, USA
1 From the Departments of Radiologic Pathology (K.K.K.) and Neuropathology (E.J.R.), Armed Forces Institute of Pathology, Washington, DC; the Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, Md (K.K.K.); and the Department of Pathology, George Washington University, Washington, DC (E.J.R.). Received June 30, 2005; accepted August 30. Both authors have no financial relationships to disclose.
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Figure 1. Well-differentiated oligodendroglioma. Photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows uniform round cells that are interrupted by a dense network of branching capillaries, a few of which are indicated by arrows.
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Figure 2. Anaplastic oligodendroglioma. Photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows florid microvascular proliferation (arrows) within a typical oligodendroglial morphology.
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Figure 3. Oligoastrocytoma. Photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows unequivocal neoplastic astrocytic (a) and oligodendroglial components combined in this field. Arrowheads = representative oligodendrocytes with the typical "fried-egg" appearance.
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Figure 4a. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 4b. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 4c. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 4d. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 4e. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 4f. Oligodendroglioma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the cortex and subcortical white matter of the right frontal lobe. (b) Axial T1-weighted magnetic resonance (MR) image shows low signal intensity of the mass, which spares the extreme perimeter of the cortical gray matter. (c) Axial T2-weighted MR image shows high signal intensity of the mass. (d) Axial apparent diffusion coefficient (ADC) MR image shows mild high signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (e) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass, a finding typical of this tumor. (f ) Photograph of the gross specimen shows expanded gyri, which are a result of neoplastic involvement. Scale is in centimeters.
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Figure 5. Oligodendroglioma. Axial CT image shows a heavily calcified mass (arrows) in the right frontal lobe without surrounding vasogenic edema.
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Figure 6a. Oligodendroglioma. (a) Axial CT image shows a peripheral, ill-defined, hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Coronal contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 6b. Oligodendroglioma. (a) Axial CT image shows a peripheral, ill-defined, hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Coronal contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 6c. Oligodendroglioma. (a) Axial CT image shows a peripheral, ill-defined, hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Coronal contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 6d. Oligodendroglioma. (a) Axial CT image shows a peripheral, ill-defined, hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Coronal contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 7a. Oligodendroglioma. (a) Axial T2-weighted MR image shows a heterogeneous hyperintense mass (arrows) in the left frontal lobe with extension to the cortex and through the genu of the corpus callosum into the right frontal lobe. (b) Axial fluid-attenuated inversion-recovery MR image shows low signal intensity in more cystlike regions (arrowheads) of the mass. (c) Axial diffusion-weighted MR image shows low signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (d) Axial contrast-enhanced T1-weighted MR image shows minimal enhancement of the mass.
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Figure 7b. Oligodendroglioma. (a) Axial T2-weighted MR image shows a heterogeneous hyperintense mass (arrows) in the left frontal lobe with extension to the cortex and through the genu of the corpus callosum into the right frontal lobe. (b) Axial fluid-attenuated inversion-recovery MR image shows low signal intensity in more cystlike regions (arrowheads) of the mass. (c) Axial diffusion-weighted MR image shows low signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (d) Axial contrast-enhanced T1-weighted MR image shows minimal enhancement of the mass.
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Figure 7c. Oligodendroglioma. (a) Axial T2-weighted MR image shows a heterogeneous hyperintense mass (arrows) in the left frontal lobe with extension to the cortex and through the genu of the corpus callosum into the right frontal lobe. (b) Axial fluid-attenuated inversion-recovery MR image shows low signal intensity in more cystlike regions (arrowheads) of the mass. (c) Axial diffusion-weighted MR image shows low signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (d) Axial contrast-enhanced T1-weighted MR image shows minimal enhancement of the mass.
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Figure 7d. Oligodendroglioma. (a) Axial T2-weighted MR image shows a heterogeneous hyperintense mass (arrows) in the left frontal lobe with extension to the cortex and through the genu of the corpus callosum into the right frontal lobe. (b) Axial fluid-attenuated inversion-recovery MR image shows low signal intensity in more cystlike regions (arrowheads) of the mass. (c) Axial diffusion-weighted MR image shows low signal intensity of the mass, a finding that indicates absence of restricted water diffusion. (d) Axial contrast-enhanced T1-weighted MR image shows minimal enhancement of the mass.
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Figure 8a. Intraventricular oligodendroglioma. (a) Axial CT image shows a heterogeneous mass (arrows) within the right lateral ventricle. (b) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (c) Axial contrast-enhanced T1-weighted MR image shows focal areas of enhancement in the mass. Findings at electron microscopy confirmed that the mass was an oligodendroglioma and not a central neurocytoma.
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Figure 8b. Intraventricular oligodendroglioma. (a) Axial CT image shows a heterogeneous mass (arrows) within the right lateral ventricle. (b) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (c) Axial contrast-enhanced T1-weighted MR image shows focal areas of enhancement in the mass. Findings at electron microscopy confirmed that the mass was an oligodendroglioma and not a central neurocytoma.
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Figure 8c. Intraventricular oligodendroglioma. (a) Axial CT image shows a heterogeneous mass (arrows) within the right lateral ventricle. (b) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (c) Axial contrast-enhanced T1-weighted MR image shows focal areas of enhancement in the mass. Findings at electron microscopy confirmed that the mass was an oligodendroglioma and not a central neurocytoma.
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Figure 9a. Anaplastic oligodendroglioma. (a) Axial CT image shows a heterogeneous mass with both cyst-like and calcified components (arrows). Extension through the corpus callosum with involvement of both frontal lobes is seen. (b) Axial contrast-enhanced CT image shows ringlike enhancement of the cystlike portion (arrowheads).
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Figure 9b. Anaplastic oligodendroglioma. (a) Axial CT image shows a heterogeneous mass with both cyst-like and calcified components (arrows). Extension through the corpus callosum with involvement of both frontal lobes is seen. (b) Axial contrast-enhanced CT image shows ringlike enhancement of the cystlike portion (arrowheads).
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Figure 10a. Anaplastic oligodendroglioma. (a) Axial T1-weighted MR image shows a mass in the right temporal lobe (arrows) with both soft-tissue and cystlike components. (b) Axial T2-weighted MR image shows heterogeneity of the mass and minimal surrounding vasogenic edema. (c) Axial contrast-enhanced MR image shows irregular ring-like enhancement of the mass (arrowheads). This appearance mimics that of a glioblastoma multiforme.
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Figure 10b. Anaplastic oligodendroglioma. (a) Axial T1-weighted MR image shows a mass in the right temporal lobe (arrows) with both soft-tissue and cystlike components. (b) Axial T2-weighted MR image shows heterogeneity of the mass and minimal surrounding vasogenic edema. (c) Axial contrast-enhanced MR image shows irregular ring-like enhancement of the mass (arrowheads). This appearance mimics that of a glioblastoma multiforme.
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Figure 10c. Anaplastic oligodendroglioma. (a) Axial T1-weighted MR image shows a mass in the right temporal lobe (arrows) with both soft-tissue and cystlike components. (b) Axial T2-weighted MR image shows heterogeneity of the mass and minimal surrounding vasogenic edema. (c) Axial contrast-enhanced MR image shows irregular ring-like enhancement of the mass (arrowheads). This appearance mimics that of a glioblastoma multiforme.
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Figure 11a. Oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the left frontal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass with mild exophytic extension beyond the normal cortical margin. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Axial contrast-enhanced MR image shows only a small focal region of enhancement (arrowhead) in the mass. (e) Intraoperative photograph shows the mass protruding beyond the normal cortical margin of the brain.
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Figure 11b. Oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the left frontal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass with mild exophytic extension beyond the normal cortical margin. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Axial contrast-enhanced MR image shows only a small focal region of enhancement (arrowhead) in the mass. (e) Intraoperative photograph shows the mass protruding beyond the normal cortical margin of the brain.
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Figure 11c. Oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the left frontal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass with mild exophytic extension beyond the normal cortical margin. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Axial contrast-enhanced MR image shows only a small focal region of enhancement (arrowhead) in the mass. (e) Intraoperative photograph shows the mass protruding beyond the normal cortical margin of the brain.
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Figure 11d. Oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the left frontal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass with mild exophytic extension beyond the normal cortical margin. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Axial contrast-enhanced MR image shows only a small focal region of enhancement (arrowhead) in the mass. (e) Intraoperative photograph shows the mass protruding beyond the normal cortical margin of the brain.
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Figure 11e. Oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the left frontal lobe. (b) Axial T1-weighted MR image shows low signal intensity of the mass with mild exophytic extension beyond the normal cortical margin. (c) Axial T2-weighted MR image shows heterogeneous high signal intensity of the mass. (d) Axial contrast-enhanced MR image shows only a small focal region of enhancement (arrowhead) in the mass. (e) Intraoperative photograph shows the mass protruding beyond the normal cortical margin of the brain.
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Figure 12a. Oligoastrocytoma. (a) Axial T1-weighted MR image shows a hypointense mass (arrow) in the right frontal lobe. (b) Axial T2-weighted MR image shows heterogeneity of the mass with exophytic extension. (c) Axial diffusion-weighted MR image shows that the mass is predominantly isointense relative to the adjacent gray matter. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 12b. Oligoastrocytoma. (a) Axial T1-weighted MR image shows a hypointense mass (arrow) in the right frontal lobe. (b) Axial T2-weighted MR image shows heterogeneity of the mass with exophytic extension. (c) Axial diffusion-weighted MR image shows that the mass is predominantly isointense relative to the adjacent gray matter. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 12c. Oligoastrocytoma. (a) Axial T1-weighted MR image shows a hypointense mass (arrow) in the right frontal lobe. (b) Axial T2-weighted MR image shows heterogeneity of the mass with exophytic extension. (c) Axial diffusion-weighted MR image shows that the mass is predominantly isointense relative to the adjacent gray matter. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 12d. Oligoastrocytoma. (a) Axial T1-weighted MR image shows a hypointense mass (arrow) in the right frontal lobe. (b) Axial T2-weighted MR image shows heterogeneity of the mass with exophytic extension. (c) Axial diffusion-weighted MR image shows that the mass is predominantly isointense relative to the adjacent gray matter. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass.
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Figure 13a. Anaplastic oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. The mass produces mild calvarial erosion. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows mild heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass. (e) Intraoperative photograph shows exophytic extension of the mass beyond the normal cortical margin.
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Figure 13b. Anaplastic oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. The mass produces mild calvarial erosion. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows mild heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass. (e) Intraoperative photograph shows exophytic extension of the mass beyond the normal cortical margin.
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Figure 13c. Anaplastic oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. The mass produces mild calvarial erosion. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows mild heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass. (e) Intraoperative photograph shows exophytic extension of the mass beyond the normal cortical margin.
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Figure 13d. Anaplastic oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. The mass produces mild calvarial erosion. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows mild heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass. (e) Intraoperative photograph shows exophytic extension of the mass beyond the normal cortical margin.
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Figure 13e. Anaplastic oligoastrocytoma. (a) Axial CT image shows a hypoattenuating mass (arrow) in the posterior portion of the right temporal lobe. The mass produces mild calvarial erosion. (b) Axial T1-weighted MR image shows low signal intensity of the mass. (c) Axial T2-weighted MR image shows mild heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows no enhancement of the mass. (e) Intraoperative photograph shows exophytic extension of the mass beyond the normal cortical margin.
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Figure 14a. Anaplastic oligoastrocytoma. (a) Axial CT image shows a heterogeneous mass (arrows) with calcifications in the right frontal lobe. (b) Axial T1-weighted MR image shows heterogeneous low signal intensity of the mass, which has both soft-tissue (s) and cystlike (c) components. (c) Axial fluid-attenuated inversion-recovery MR image shows similar heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows irregular ringlike enhancement of the mass and abnormal leptomeningeal enhancement.
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Figure 14b. Anaplastic oligoastrocytoma. (a) Axial CT image shows a heterogeneous mass (arrows) with calcifications in the right frontal lobe. (b) Axial T1-weighted MR image shows heterogeneous low signal intensity of the mass, which has both soft-tissue (s) and cystlike (c) components. (c) Axial fluid-attenuated inversion-recovery MR image shows similar heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows irregular ringlike enhancement of the mass and abnormal leptomeningeal enhancement.
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Figure 14c. Anaplastic oligoastrocytoma. (a) Axial CT image shows a heterogeneous mass (arrows) with calcifications in the right frontal lobe. (b) Axial T1-weighted MR image shows heterogeneous low signal intensity of the mass, which has both soft-tissue (s) and cystlike (c) components. (c) Axial fluid-attenuated inversion-recovery MR image shows similar heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows irregular ringlike enhancement of the mass and abnormal leptomeningeal enhancement.
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Figure 14d. Anaplastic oligoastrocytoma. (a) Axial CT image shows a heterogeneous mass (arrows) with calcifications in the right frontal lobe. (b) Axial T1-weighted MR image shows heterogeneous low signal intensity of the mass, which has both soft-tissue (s) and cystlike (c) components. (c) Axial fluid-attenuated inversion-recovery MR image shows similar heterogeneity of the mass. (d) Axial contrast-enhanced T1-weighted MR image shows irregular ringlike enhancement of the mass and abnormal leptomeningeal enhancement.
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Copyright © 2005 by the Radiological Society of North America.
