The Usefulness of MR Imaging in the Diagnosis of Dysembryoplastic Neuroepithelial Tumor in Children: A Study of 14 Cases
Carla Fernandeza,
Nadine Girardb,
Armando Paz Paredesc,
Corinne Bouvier-Labita,
Gabriel Lenac and
Dominique Figarella-Brangera
a Department of Pathology and Neuropathology, Hôpital d’Enfants de la Timone, Marseille, France
b Department of Neuroradiology, Hôpital d’Enfants de la Timone, Marseille, France
c Department of Pediatric Neurosurgery, Hôpital d’Enfants de la Timone, Marseille, France
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FIG 1. Typical DNT findings.
A, Sagittal T1-weighted MR image shows a large lesion of low signal intensity involving the temporal lobe, without edema or mass effect and corresponding to a complex form of DNT. The lesion is divided by septations leading to an alveolar aspect.
B, The lesion is of high signal intensity on this T2-weighted MR image. The septations appear to be of low signal intensity.
C, Sagittal T1-weighted MR image shows a frontoparietal DNT with sharp boundaries and a rectangular pattern of distribution.
D, Coronal T2-weighted MR image illustrates the triangular pattern of distribution typical of DNT, with a tumor width that is maximal at the cortical level and decreases toward brain ventricles.
E, Low-magnification view showing the cortical location and the nodular architecture typical of DNT (hematoxylin phloxin-saffron, magnification x10).
F, The glio-neuronal specific element is composed of oligodendrocyte-like cells surrounding areas of mucoid substance containing "floating neurons" (hematoxylin phloxin-saffron, magnification x300).
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FIG 2. DNT involving the occipital lobe and presenting hemorrhagic changes (case 7).
A, On CT scan, the lesion appears of low attenuation and shows a nodular enhancement after contrast injection.
B and C, On transverse (B) and sagittal (C) T1-weighted MR images, the DNT is of low signal intensity, displays septations, but shows three areas of hyperintensity after gadolinium injection, mimicking a glioma.
D, Transverse T2-weighted MR image shows the absence of edema and mass effect on median structure.
E, Marked nuclear atypias can be observed in the glial areas of DNT (hematoxylin phloxin-saffron, magnification x200).
F, An oligodendroglioma-like area showing major hemorrhagic changes characterized by numerous hemosiderin-laden histiocytes (hematoxylin phloxin-saffron, magnification x200).
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