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Medulloblastoma with Extensive Nodularity: Single Photon Emission CT Study with Iodine-123 Metaiodobenzylguanidine

Yuichiro Naitoha, Toshio Sasajimaa, Hiroyuki Kinouchia, Shigeki Mikawaa and Kazuo Mizoia

a From the Department of Neurosurgery, Akita University School of Medicine, Akita, Japan



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  		FIG 1. Axial view MR images show an equivocal nodularity with surrounding high T2-weighted signal intensity in the tumor.

A, T1-weighted image (380/10/2 [TR/TE/NEX]).

B, Contrast-enhanced T1-weighted image (380/10/2) reveals a grape-like enhancing tumor occupying the upper part of the posterior fossa.

C, T2-weighted image (4500/100/2).



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  		FIG 2. Axial view iodine-123 metaiodobenzylguanidine SPECT scans, obtained 30 minutes (left) and 6 hours (right) after an IV injection of iodine-123 metaiodobenzylguanidine at a dose of 111 MBq, shows extremely high uptake in the tumor.



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  		FIG 3. Photomicrograph shows lobulated areas (pale islands) in the tumor (upper, hematoxylin and eosin staining; original magnification, x50). Within a typical "pale island" area, streaming of uniform and round cells can be seen, arranged in parallel rows (lower, hematoxylin and eosin staining; original magnification, x200).



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  		FIG 4. Electron micrograph from a typical "pale island" focus reveals dense-cored vesicles (black arrows) and a spherical vesicle-like structure (white arrows).





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X