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A 33 year-old man developed headaches and a depressed affect. |
Low Grade Glioma. (Left)
Flair coronal MRI; (Right) Flair parasagittal MRI. Note the lesion in the left frontal lobe anterior to the
precentral sulcus in the superior frontal gyrus. This lesion did not
enhance with gadolinium. Also note that there is very little mass
effect. This is a low grade glioma (astrocytoma). Low-grade gliomas make up 15% of all primary intracranial brain tumors, and usually occur in young adults. They are named according to the specific type of glial cell that they derive from, and include astrocytomas, oligodendrogliomas, ependymomas, and mixed gliomas such as oligoastrocytomas that contain a mixture of different types of glial cells. Although biopsy is required to make a definitive diagnosis, the lack of contrast enhancement favors the diagnosis of a low grade glioma rather than a glioblastoma. Certain genetic conditions are predisposed to the formation of gliomas (e.g., neurofibromatosis, tuberous sclerosis). Clinical signs and symptoms depend on location. Headache and focal (or focal to generalized) seizures are common. Focal neurological deficits can occur. The World Health Organization scheme for grading gliomas from benign to progressively more malignant is as follows: ● Grade I - Pilocytic Pilocytic tumors are very benign histologically and typically
occur in children. Low-grade tumors can be slow growing and
controlled by surgical resection. If they recur, they are usually higher
grade tumors. Anaplastic tumors are malignant tumors with mitoses
and nuclear atypia. |
Revised
11/30/06.
Copyrighted 2006. David C Preston