Can Tumor Contrast Enhancement Be Used as a Criterion for Differentiating Tumor Grades of Oligodendrogliomas?
Matthew L. Whitea,
Yan Zhanga,
Patricia Kirbyb and
Timothy C. Rykenc
a Department of Radiology, University of Iowa College of Medicine, Iowa City
b Department of Pathology, University of Iowa College of Medicine, Iowa City
c Department of Neurosurgery, University of Iowa College of Medicine, Iowa City
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FIG 1. Anaplastic oligodendroglioma obtained in a 28-year-old man.
A, Axial T2-weighted (3588/99 TR/TE) fast SE image shows a high-signal-intensity mass in the left frontal lobe.
B, Axial T1-weighted (540/14) image shows that the mass has low signal intensity.
C, Axial contrast-enhanced T1-weighted (540/14) image shows nodular-like enhancement within the mass.
D, Photomicrograph of the specimen (hematoxylin-eosin stain; original magnification, x25) shows a nodular area that has the high-grade features consisting of high cellularity and nuclear hyperchromasia; however, this is not a specifically sampled area of the nodular-like enhancement on the T1-weighted image. Note the area of necrosis (arrows).
E, Photomicrograph of the specimen (hematoxylin-eosin stain; original magnification, x25) shows the area that has the relatively low-grade features, such as even cellularity and little nuclear pleomorphism. No necrosis is present.
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FIG 2. Anaplastic oligodendroglioma in a 47-year-old woman.
A, Axial T2-weighted (3200/96) fast SE image shows a high-signal-intensity mass that mainly involves the right frontal lobe and insula.
B, Axial T1-weighted (583/20) image shows that the mass is isointense to slightly hypointense.
C, Axial contrast-enhanced T1-weighted (583/20) image does not show obvious tumor contrast enhancement. The CER is 5.82.
D, Photomicrograph of the specimen (hematoxylin-eosin stain; original magnification x40) shows high cellularity, nuclear pleomorphism and hyperchromasia, and mitosis (arrow). There is no increased neovascularity.
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FIG 3. Low-grade oligodendroglioma in a 42-year-old man.
A, Axial T2-weighted (4750/105) fast SE image shows a high-signal-intensity mass in the right frontal lobe.
B, Axial T1-weighted (466/14) image shows that the mass is isointense to slightly hyperintense.
C, Axial contrast-enhanced T1-weighted (466/14) image shows partial tumor contrast enhancement. The contrast enhancement ratio is 40.88.
D, Photomicrograph of the specimen (hematoxylin-eosin stain; original magnification, x40) shows even cellularity and little nuclear pleomorphism and hyperchromasia. No mitosis or necrosis is present. There is no increased neovascularity.
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FIG 4. Anaplastic oligodendroglioma in a 59-year-old man.
A, Axial T2-weighted (3986/99) fast SE image shows a high-signal-intensity mass in the right temporal and frontal lobes.
B, Axial T1-weighted (600/14) image shows that the mass is isointense to slightly hyperintense.
C, Axial contrast-enhanced T1-weighted (600/14) image shows the inhomogeneous and partial tumor contrast enhancement with a CER up to 62.52. There are nodular-like enhancement areas within the tumor.
D, Photomicrograph of the specimen (hematoxylin-eosin stain; original magnification, x100) shows an area with high cellularity and increased neovascularity.
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