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Figures
- Fig 1.
Appearance of the solid tumor component on various sequences. Axial T2 (A and B), axial T2 FLAIR (C), and T1 FLAIR (D) images showed a predominantly cystic mass in the right cerebral hemisphere with a heterogeneous solid component (black arrows in B, and H; white arrows in C–G) along the medial aspect of the tumor margin. A single thin septation was present within the cystic component (dashed black arrow, A). There is significant associated mass effect with T2 hyperintensity in the adjacent right parietal lobe white matter (white dashed arrow, A), a leftward midline shift, and compression of the right basal ganglia, brain stem, and right cerebral and middle cerebellar peduncles. The left lateral ventricle (asterisks) and third ventricle (not shown) were obstructed, causing marked ventricular dilation. Avid enhancement of the solid component is demonstrated in the axial (D) and coronal (E) T1WI + Gadolinium images. Heterogeneous mild intralesional restricted diffusion (G and H) is atypical for these tumors.
- Fig 2.
Intraoperative photograph of the tumor, after opening and draining of the cystic portion. The remaining mixed solid and cystic nodule is seen along the medial aspect of the tumor (arrows).
- Fig 3.
Hematoxylin eosin–stained photomicrograph demonstrates the characteristic fascicular/storiform arrangement of the prominent spindle-shaped glial component of the tumor (A, scaled from 100×). These cells are glial fibrillary acid protein positive (confirming their glial origin) (B, scaled from 200×), and an abundant pericellular connective tissue network is highlighted by the methyl blue component of a Mason trichrome stain (C, scaled from 100×). Rare ganglion cells are present (arrow), which are highlighted by Synaptophysin immunostaining (D, scaled from 400×).
- Fig 4.
Illustration (A) and example (B and C) of a DIT with typical features. The tumors are exclusively supratentorial and voluminous and are made up of both cystic (asterisks) components and a peripheral mural nodule (straight arrows). Significant associated mass effect and midline shift (curved arrow) are often present. Illustration (A), Used with permission of Mayo Foundation for Medical Education and Research. All rights reserved.
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