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AJNR - American Journal of Neuroradiology

Published ahead of print on September 28, 2007
doi: 10.3174/ajnr.A0695

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Relatively Decreased ¹¹C-Methionine Uptake within the Anaplastic Component of a Mixed-Grade Oligodendroglioma

K. Miwa^a, J. Shinoda^a, H. Yano^b and T. Iwama^b

^a Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Department of Neurosurgery, Kizawa Memorial Hospital, Gifu, Japan
^b Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan

View larger version (37K): [in this window] [in a new window]   Fig 1. Imaging findings at initial imaging. A, Gadolinium-enhanced T1-weighted MR imaging demonstrates an enhanced mass lesion with a large cyst in the right frontal lobe. B, MET-PET image demonstrates intense high uptake of MET in the anterior right frontal lobe (tumor area A: short arrow), moderate uptake of MET in the anteromedial right frontal lobe (tumor area B: long arrow), and intense uptake of MET in the posteromedial right frontal lobe (tumor area C: arrowhead). C, MET-PET image coregistered with gadolinium-enhanced MR imaging. On coregistered images, tumor area B was intensively enhanced with gadolinium (long arrow), but tumor areas A and C had no gadolinium enhancement (short arrow and arrowhead, respectively). D, CT scans demonstrate a cystic right frontal mass with calcification. Tumor area C almost completely corresponded with the calcified lesion.

View larger version (102K): [in this window] [in a new window]   Fig 2. Histologic findings of tumor area A (A and B), tumor area B (C and D), and tumor area C (E and F). (H&E, x200 [A, C, and E], MIB-1 immunostaining, hematoxylin counterstaining, x200 [B, D, and F].) A, Tumor area A is moderately cellular and composed of cells with rounded, homogeneous nuclei and a swollen, clear cytoplasm (honeycomb appearance), consistent with low-grade oligodendroglioma. B, Tumor area A has MIB-1 positive cells and an MIB-1 labeling index of 1.8%. C, Tumor area B shows increased cellularity, marked cytological atypia, and high percentage of mitotic activity, consistent with high-grade (anaplastic) oligodendroglioma. D, Tumor area B shows frequent MIB-1 positive cells and an MIB-1 labeling index of 7.6%. E, Tumor area C is moderately cellular and composed of cells with rounded, homogeneous nuclei with calcification, consistent with low-grade oligodendroglioma. F, Tumor area C shows MIB-1 positive cells and an MIB-1 labeling index of 2.2%.