Germinoma CT: Difference between revisions
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==Overview== | ==Overview== | ||
Head and neck CT scan may be diagnostic of germinoma. Findings on CT scan suggestive of germinoma include hyperdensity compared to adjacent brain, pituitary stalk enhancement and thickening, and presence of calcification in the pineal region in the pediatric population.<ref name="radio"> Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016</ref> | Head and neck CT scan may be diagnostic of germinoma. Findings on [[CT scan]] suggestive of germinoma include hyperdensity compared to adjacent brain, [[pituitary stalk]] enhancement and thickening, and presence of [[calcification]] in the pineal region in the pediatric population.<ref name="radio"> Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016</ref> | ||
==CT== | ==CT== | ||
*On CT the high cellularity results in a degree to hyperdensity compared to adjacent brain. Usually the mass enhances brightly. | *On CT the high cellularity results in a degree to hyperdensity compared to adjacent brain. Usually the mass enhances brightly. | ||
*When in the floor of the third ventricle it is typically seen filling and expanding the infundibular recess and supraoptic recess. | *When in the floor of the third ventricle it is typically seen filling and expanding the infundibular recess and supraoptic recess. | ||
*Imaging may however be normal initially and if the diagnosis is suspected clinically (e.g. idiopathic hypothalamic diabetes insipidus) then close followup is required to identify potentially very subtle abnormal pituitary stalk enhancement and thickening. | *Imaging may however be normal initially and if the diagnosis is suspected clinically (e.g. idiopathic hypothalamic [[diabetes insipidus]]) then close followup is required to identify potentially very subtle abnormal pituitary stalk enhancement and thickening. | ||
*In the paediatric population presence of calcification in the pineal region is a useful marker of an underlying | *In the paediatric population presence of [[calcification]] in the pineal region is a useful marker of an underlying [[tumor]], as no calcification of the pineal is seen in children below the age of 6.5 and in only ~10% of children between 11 and 14 years of age.<ref name="radio"> Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016</ref> | ||
*Germinomas show a homogeneous pattern and are hyperdense compared with brain tissue whereas nongerminomatous tumors NGGTS are irregular in shape, with edema, and are less dense than germinomas. Mature teratomas have mixed densities, with areas of calcification with distinct tumor margins and with large cysts. | *Germinomas show a homogeneous pattern and are hyperdense compared with brain tissue whereas nongerminomatous tumors NGGTS are irregular in shape, with edema, and are less dense than germinomas. Mature teratomas have mixed densities, with areas of calcification with distinct tumor margins and with large cysts. | ||
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Sagittal non contrast CT.jpg|Sagittal non contrast CT of germinoma of CNS<ref name="radio1">Image courtesy of Dr Hani Al Salam [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref> | |||
Aial non contrast CT.jpg|Axial non contrast CT of germinoma<ref name="radio1">Image courtesy of Dr Hani Al Salam [http://radiopaedia.org/images/344845] (original file [http://radiopaedia.org/cases/germinoma]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref> | |||
</gallery> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [4]
Overview
Head and neck CT scan may be diagnostic of germinoma. Findings on CT scan suggestive of germinoma include hyperdensity compared to adjacent brain, pituitary stalk enhancement and thickening, and presence of calcification in the pineal region in the pediatric population.[1]
CT
- On CT the high cellularity results in a degree to hyperdensity compared to adjacent brain. Usually the mass enhances brightly.
- When in the floor of the third ventricle it is typically seen filling and expanding the infundibular recess and supraoptic recess.
- Imaging may however be normal initially and if the diagnosis is suspected clinically (e.g. idiopathic hypothalamic diabetes insipidus) then close followup is required to identify potentially very subtle abnormal pituitary stalk enhancement and thickening.
- In the paediatric population presence of calcification in the pineal region is a useful marker of an underlying tumor, as no calcification of the pineal is seen in children below the age of 6.5 and in only ~10% of children between 11 and 14 years of age.[1]
- Germinomas show a homogeneous pattern and are hyperdense compared with brain tissue whereas nongerminomatous tumors NGGTS are irregular in shape, with edema, and are less dense than germinomas. Mature teratomas have mixed densities, with areas of calcification with distinct tumor margins and with large cysts.
![Sagittal non contrast CT of germinoma of CNS[2]](/index.php/File:Sagittal_non_contrast_CT.jpg)
![Axial non contrast CT of germinoma[2]](/index.php/File:Aial_non_contrast_CT.jpg)
References
- ↑ 1.0 1.1 Germinoma. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016
- ↑ 2.0 2.1 Image courtesy of Dr Hani Al Salam [1] (original file [2]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC