Pituitary adenoma differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
{{Pituitary adenoma}}
{{Pituitary adenoma}}
{{CMG}} {{AE}} {{AAM}}
{{CMG}} {{AE}} {{Fs}}
==Overview==
==Overview==
Pituitary adenoma must be differentiated from other diseases such as [[craniopharyngioma]], [[meningioma]], [[arachnoid cyst]], and [[pituitary cancer|pituitary carcinoma]].
 
==Differential Diagnosis==
==Differential Diagnosis==
Pituitary adenoma should be differentiated from other diseases such as:<ref name=Librepathology> http://librepathology.org/wiki/index.php/Pituitary_gland#Pituitary_adenoma. Pituitary adenoma. Accessed on 09/24/2015</ref>
=== Differentiating astrocytoma from other diseases on the basis of seizure, visual disturbance, and constitutional symptoms ===
*Rathke cleft cyst
On the basis of seizure, visual disturbance, and constitutional symptoms, astrocytoma must be differentiated from [[oligodendroglioma]], [[meningioma]], [[hemangioblastoma]], [[pituitary adenoma]], [[schwannoma]], [[Primary central nervous system lymphoma|primary CNS lymphoma]], [[medulloblastoma]], [[ependymoma]], [[craniopharyngioma]], [[pinealoma]], [[Arteriovenous malformation|AV malformation]], [[brain aneurysm]], [[bacterial]] [[brain]] [[abscess]], [[tuberculosis]], [[toxoplasmosis]], [[hydatid cyst]], [[CNS]] [[cryptococcosis]], [[CNS]] [[aspergillosis]], and [[brain metastasis]].
*[[Craniopharyngioma]]
{|
*[[Germ cell tumor]]
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
*[[Meningioma]]
! colspan="2" rowspan="4" |Diseases
*[[Chordoma]]
| colspan="5" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
*[[Arachnoid cyst]]
! colspan="3" rowspan="2" |Para-clinical findings
*[[Pituitary cancer|Pituitary carcinoma]]
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold<br>standard'''
*Epidermoid of brain
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
==DIfferentiating Pituitary adenoma from other diseases==
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical examination
|-
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Immunohistopathology
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Head-<br>ache
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Seizure
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Visual disturbance
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Constitutional
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Focal neurological deficit
|-
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |Adult primary brain tumors
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glioblastoma multiforme]]<br><ref name="pmid17964028">{{cite journal |vauthors=Sathornsumetee S, Rich JN, Reardon DA |title=Diagnosis and treatment of high-grade astrocytoma |journal=Neurol Clin |volume=25 |issue=4 |pages=1111–39, x |date=November 2007 |pmid=17964028 |doi=10.1016/j.ncl.2007.07.004 |url=}}</ref><ref name="pmid22819718">{{cite journal |vauthors=Pedersen CL, Romner B |title=Current treatment of low grade astrocytoma: a review |journal=Clin Neurol Neurosurg |volume=115 |issue=1 |pages=1–8 |date=January 2013 |pmid=22819718 |doi=10.1016/j.clineuro.2012.07.002 |url=}}</ref><ref name=":0">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" |−
| style="background: #F5F5F5; padding: 5px;" |
* [[Supratentorial]]
* Irregular ring-nodular enhancing lesions
* Central [[necrosis]]
* Surrounding [[vasogenic edema]]
 
* Cross [[corpus callosum]] ([[butterfly glioma]])
| style="background: #F5F5F5; padding: 5px;" |
* [[Astrocyte]] origin
 
* [[Pleomorphism|Pleomorphic]] cell
 
* Pseudopalisading appearance
 
* [[GFAP]] +
 
* [[Necrosis]] +


<small>
* [[Hemorrhage]] +
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align="center"


|+
* [[Vascular]] prolifration +
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Disease}}
| style="background: #F5F5F5; padding: 5px;" |
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Gene}}
* [[Biopsy]]
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Chromosome}}
| style="background: #F5F5F5; padding: 5px;" |
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differentiating Features}}
* Highest [[incidence]] in fifth and sixth decades of life
! colspan="3" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Components of MEN}}
* Most of the time, focal [[neurological]] deficit is the presenting [[Sign (medical)|sign]].
! rowspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Diagnosis}}
|-
|-
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Parathyroid}}
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[oligodendroglioma]]<br><ref name="pmid26849038">{{cite journal |vauthors=Smits M |title=Imaging of oligodendroglioma |journal=Br J Radiol |volume=89 |issue=1060 |pages=20150857 |date=2016 |pmid=26849038 |pmc=4846213 |doi=10.1259/bjr.20150857 |url=}}</ref><ref name="pmid25943885">{{cite journal |vauthors=Wesseling P, van den Bent M, Perry A |title=Oligodendroglioma: pathology, molecular mechanisms and markers |journal=Acta Neuropathol. |volume=129 |issue=6 |pages=809–27 |date=June 2015 |pmid=25943885 |pmc=4436696 |doi=10.1007/s00401-015-1424-1 |url=}}</ref><ref name="pmid26478444">{{cite journal |vauthors=Kerkhof M, Benit C, Duran-Pena A, Vecht CJ |title=Seizures in oligodendroglial tumors |journal=CNS Oncol |volume=4 |issue=5 |pages=347–56 |date=2015 |pmid=26478444 |pmc=6082346 |doi=10.2217/cns.15.29 |url=}}</ref>
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Pitutary}}
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Pancreas}}
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="background: #F5F5F5; padding: 5px;" |
* Almost always in [[Cerebral hemisphere|cerebral hemisphers]] ([[Frontal lobe|frontal lobes]])
 
* Hypointense on T1
* Hyperintense on T2
* [[Calcification]]
 
* Chicken wire capillary pattern
| style="background: #F5F5F5; padding: 5px;" |
* [[Oligodendrocyte]] origin
 
* [[Calcification]] +
 
* Fried egg cell appearance
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Highest [[incidence]] is between 40 and 50 years of age.
* Most of the time, [[epileptic seizure]] is the presenting [[Sign (medicine)|sign]].
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[von Hippel-Lindau syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Meningioma]]<br><ref name="pmid1642904">{{cite journal |vauthors=Zee CS, Chin T, Segall HD, Destian S, Ahmadi J |title=Magnetic resonance imaging of meningiomas |journal=Semin. Ultrasound CT MR |volume=13 |issue=3 |pages=154–69 |date=June 1992 |pmid=1642904 |doi= |url=}}</ref><ref name="pmid25744347">{{cite journal |vauthors=Shibuya M |title=Pathology and molecular genetics of meningioma: recent advances |journal=Neurol. Med. Chir. (Tokyo) |volume=55 |issue=1 |pages=14–27 |date=2015 |pmid=25744347 |doi=10.2176/nmc.ra.2014-0233 |url=}}</ref><ref name="pmid17509660">{{cite journal |vauthors=Begnami MD, Palau M, Rushing EJ, Santi M, Quezado M |title=Evaluation of NF2 gene deletion in sporadic schwannomas, meningiomas, and ependymomas by chromogenic in situ hybridization |journal=Hum. Pathol. |volume=38 |issue=9 |pages=1345–50 |date=September 2007 |pmid=17509660 |pmc=2094208 |doi=10.1016/j.humpath.2007.01.027 |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Von Hippel–Lindau tumor suppressor
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |3p25.3
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* Angiomatosis, 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Hemangioblastomas,
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* Pheochromocytoma, 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Renal cell carcinoma,
| style="background: #F5F5F5; padding: 5px;" |
* Pancreatic cysts (pancreatic serous cystadenoma)
* Well circumscribed
* Endolymphatic sac tumor,
* Extra-axial [[mass]]
* Bilateral papillary cystadenomas of the epididymis (men) or broad ligament of the uterus (women)
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* [[Meninges|Dural]] attachment
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* [[CSF]] [[vascular]] cleft sign
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | +
* Sunburst appearance of the [[Vessel|vessels]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px;" |
* Clinical diagnosis
* [[Arachnoid]] origin
* In hereditary VHL, disease techniques such as Southern blotting and gene sequencing can be used to analyse DNA and identify mutations.
 
* [[Psammoma body|Psammoma bodies]]
 
* Whorled spindle cell pattern
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Highest [[incidence]] is between 40 and 50 years of age.
* Most of the time, focal [[neurological]] deficit and [[epileptic seizure]] are the presenting [[signs]].
 
* May be associated with [[Neurofibromatosis type II|NF-2]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Carney complex]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemangioblastoma]]<br><ref name="pmid24579662">{{cite journal |vauthors=Lonser RR, Butman JA, Huntoon K, Asthagiri AR, Wu T, Bakhtian KD, Chew EY, Zhuang Z, Linehan WM, Oldfield EH |title=Prospective natural history study of central nervous system hemangioblastomas in von Hippel-Lindau disease |journal=J. Neurosurg. |volume=120 |issue=5 |pages=1055–62 |date=May 2014 |pmid=24579662 |pmc=4762041 |doi=10.3171/2014.1.JNS131431 |url=}}</ref><ref name="pmid17877533">{{cite journal |vauthors=Hussein MR |title=Central nervous system capillary haemangioblastoma: the pathologist's viewpoint |journal=Int J Exp Pathol |volume=88 |issue=5 |pages=311–24 |date=October 2007 |pmid=17877533 |pmc=2517334 |doi=10.1111/j.1365-2613.2007.00535.x |url=}}</ref><ref name="pmid2704812">{{cite journal |vauthors=Lee SR, Sanches J, Mark AS, Dillon WP, Norman D, Newton TH |title=Posterior fossa hemangioblastomas: MR imaging |journal=Radiology |volume=171 |issue=2 |pages=463–8 |date=May 1989 |pmid=2704812 |doi=10.1148/radiology.171.2.2704812 |url=}}</ref><ref name="pmid945331">{{cite journal |vauthors=Perks WH, Cross JN, Sivapragasam S, Johnson P |title=Supratentorial haemangioblastoma with polycythaemia |journal=J. Neurol. Neurosurg. Psychiatry |volume=39 |issue=3 |pages=218–20 |date=March 1976 |pmid=945331 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"| PRKAR1A
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"| 17q23-q24
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"|
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* Myxomas of the heart
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Hyperpigmentation of the skin (lentiginosis)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* Endocrine (ACTH-independent Cushing's syndrome due to primary pigmented nodular adrenocortical disease)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* [[Infratentorial]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
* [[Cyst|Cystic]] lesion with a solid enhancing mural [[nodule]]
* Clinical diagnosis
| style="background: #F5F5F5; padding: 5px;" |
* [[Blood vessel]] origin
 
* [[Capillary|Capillaries]] with thin walls
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Might secret [[erythropoietin]] and cause [[polycythemia]]
* May be associated with [[Von Hippel-Lindau Disease|von hippel-lindau syndrome]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Neurofibromatosis type 1]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pituitary adenoma]]<br><ref name="pmid3786729">{{cite journal |vauthors=Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH |title=Pituitary adenomas: high-resolution MR imaging at 1.5 T |journal=Radiology |volume=161 |issue=3 |pages=761–5 |date=December 1986 |pmid=3786729 |doi=10.1148/radiology.161.3.3786729 |url=}}</ref><ref name="pmid22584705">{{cite journal |vauthors=Syro LV, Scheithauer BW, Kovacs K, Toledo RA, Londoño FJ, Ortiz LD, Rotondo F, Horvath E, Uribe H |title=Pituitary tumors in patients with MEN1 syndrome |journal=Clinics (Sao Paulo) |volume=67 Suppl 1 |issue= |pages=43–8 |date=2012 |pmid=22584705 |pmc=3328811 |doi= |url=}}</ref><ref name=":0" />
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"|RAS
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"|17
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold"|
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + [[Bitemporal hemianopia]]
* [[Scoliosis]]  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Learning disabilities
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Vision]] disorders
| style="background: #F5F5F5; padding: 5px;" |  
* Cutaneous [[lesion]]s
* [[Endocrine]] abnormalities as a result of [[Pituitary adenoma|functional adenomas]] or pressure effect of non-functional [[Adenoma|adenomas]]
* [[Epilepsy]].
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* Isointense to normal [[pituitary gland]] in T1
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* [[Endocrine]] cell [[hyperplasia]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |'''<u>Prenatal</u>'''
| style="background: #F5F5F5; padding: 5px;" |
* Chorionic villus sampling or amniocentesis can be used to detect NF-1 in the fetus.
* [[Biopsy]]
'''<u>Postnatal</u>'''
| style="background: #F5F5F5; padding: 5px;" |
Cardinal Clinical Features" are required for positive diagnosis.
* It is associated with [[MEN1]] disease.
* Six or more café-au-lait spots over 5 mm in greatest diameter in pre-pubertal individuals and over 15 mm in greatest diameter in post-pubertal individuals.
 
* Two or more neurofibromas of any type or 1 plexiform neurofibroma
* Initialy presents with upper bitemporal quadrantanopsia followed by [[Bitemporal hemianopia|bitemporal hemianopsia]] (pressure on [[Optic chiasm|optic chiasma]] from below)
* Freckling in the axillary (Crowe sign) or inguinal regions
 
* Optic glioma
*
* Two or more Lisch nodules (pigmented iris hamartomas)
 
* A distinctive osseous lesion such as sphenoid dysplasia, or thinning of the long bone cortex with or without pseudarthrosis.
*  
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Li-Fraumeni syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Schwannoma]]<br><ref name="DonnellyDaly2007">{{cite journal|last1=Donnelly|first1=Martin J.|last2=Daly|first2=Carmel A.|last3=Briggs|first3=Robert J. S.|title=MR imaging features of an intracochlear acoustic schwannoma|journal=The Journal of Laryngology & Otology|volume=108|issue=12|year=2007|issn=0022-2151|doi=10.1017/S0022215100129056}}</ref><ref name="pmid9639114">{{cite journal |vauthors=Feany MB, Anthony DC, Fletcher CD |title=Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge |journal=Histopathology |volume=32 |issue=5 |pages=405–10 |date=May 1998 |pmid=9639114 |doi= |url=}}</ref><ref name="pmid28710469">{{cite journal |vauthors=Chen H, Xue L, Wang H, Wang Z, Wu H |title=Differential NF2 Gene Status in Sporadic Vestibular Schwannomas and its Prognostic Impact on Tumour Growth Patterns |journal=Sci Rep |volume=7 |issue=1 |pages=5470 |date=July 2017 |pmid=28710469 |doi=10.1038/s41598-017-05769-0 |url=}}</ref><ref name="HardellHansson Mild2003">{{cite journal|last1=Hardell|first1=Lennart|last2=Hansson Mild|first2=Kjell|last3=Sandström|first3=Monica|last4=Carlberg|first4=Michael|last5=Hallquist|first5=Arne|last6=Påhlson|first6=Anneli|title=Vestibular Schwannoma, Tinnitus and Cellular Telephones|journal=Neuroepidemiology|volume=22|issue=2|year=2003|pages=124–129|issn=0251-5350|doi=10.1159/000068745}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |TP53
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |17
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Early onset of diverse amount of [[cancer]]s such as
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Sarcoma]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Cancer]]s of 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
** [[Breast]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
** [[Brain]]  
| style="background: #F5F5F5; padding: 5px;" |
** [[Adrenal gland]]s
* Split-fat sign
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* Fascicular sign
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* Often have areas of [[hemosiderin]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
* [[Schwann cell]] origin
'''<u>Criteria</u>'''
 
* Sarcoma at a young age (below 45)
* S100+
* A first-degree relative diagnosed with any cancer at a young age (below 45)
| style="background: #F5F5F5; padding: 5px;" |
* A first or second degree relative with any cancer diagnosed before age 60.
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* It causes [[hearing loss]] and [[tinnitus]]
 
* May be associated with [[Neurofibromatosis type II|NF-2]] (bilateral [[Schwannoma|schwannomas]])
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Gardner's syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Primary central nervous system lymphoma|Primary CNS lymphoma]]<br><ref name="pmid7480733">{{cite journal |vauthors=Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ |title=Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy |journal=Radiology |volume=197 |issue=3 |pages=649–54 |date=December 1995 |pmid=7480733 |doi=10.1148/radiology.197.3.7480733 |url=}}</ref><ref name="Paulus19992">{{cite journal|last1=Paulus|first1=Werner|journal=Journal of Neuro-Oncology|title=Classification, Pathogenesis and Molecular Pathology of Primary CNS Lymphomas|volume=43|issue=3|year=1999|pages=203–208|issn=0167594X|doi=10.1023/A:1006242116122}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | APC
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | 5q21
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* Multiple polyps in the colon 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Osteomas of the skull
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* Thyroid cancer,
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Epidermoid cysts,
| style="background: #F5F5F5; padding: 5px;" |
* Fibromas
* Usually deep in the [[white matter]]
* Desmoid tumors
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* Single [[mass]] with ring enhancement
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
* [[B cell]] origin
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
 
* Clinical diagnosis
* Similar to [[Non-Hodgkin lymphoma|non hodgkin lymphoma]] ([[Diffuse large B cell lymphoma|diffuse large B cell]])
* Colonoscopy
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Usually in young [[immunocompromised]] patients ([[HIV]]) or old [[immunocompetent]] person.
 
*
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Multiple endocrine neoplasia type 2]]
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |Childhood primary brain tumors
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |''RET''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pilocytic astrocytoma]]<br><ref name="pmid179640282">{{cite journal |vauthors=Sathornsumetee S, Rich JN, Reardon DA |title=Diagnosis and treatment of high-grade astrocytoma |journal=Neurol Clin |volume=25 |issue=4 |pages=1111–39, x |date=November 2007 |pmid=17964028 |doi=10.1016/j.ncl.2007.07.004 |url=}}</ref><ref name="pmid228197182">{{cite journal |vauthors=Pedersen CL, Romner B |title=Current treatment of low grade astrocytoma: a review |journal=Clin Neurol Neurosurg |volume=115 |issue=1 |pages=1–8 |date=January 2013 |pmid=22819718 |doi=10.1016/j.clineuro.2012.07.002 |url=}}</ref><ref name=":02">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* [[Medullary thyroid carcinoma]] (MTC)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* [[Pheochromocytoma]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Primary [[hyperparathyroidism]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
* [[Infratentorial]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
 
* [[Hypercalcemia]]
* Solid and [[Cyst|cystic]] component
* [[Hypophosphatemia]],
* Mostly in [[posterior fossa]]
* Elevated [[parathyroid hormone]],
* Usually in [[Cerebellar hemisphere|cerebellar hemisphers]] and [[Cerebellar vermis|vermis]]
* Elevated [[norepinephrine]]
| style="background: #F5F5F5; padding: 5px;" |
'''<u>Criteria</u>'''
* [[Glial cell]] origin
Two or more specific endocrine tumors
*Solid and [[Cyst|cystic]] component
* [[Medullary thyroid carcinoma]]
 
* [[Pheochromocytoma]]
* [[GFAP]] +
* [[Parathyroid]] hyperplasia
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Most of the time, [[Cerebellum|cerebellar]] dysfunction is the presenting [[signs]].
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Cowden syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Medulloblastoma]]<br><ref name="DorwartWara1981">{{cite journal|last1=Dorwart|first1=R H|last2=Wara|first2=W M|last3=Norman|first3=D|last4=Levin|first4=V A|title=Complete myelographic evaluation of spinal metastases from medulloblastoma.|journal=Radiology|volume=139|issue=2|year=1981|pages=403–408|issn=0033-8419|doi=10.1148/radiology.139.2.7220886}}</ref><ref name="Fruehwald-PallamarPuchner2011">{{cite journal|last1=Fruehwald-Pallamar|first1=Julia|last2=Puchner|first2=Stefan B.|last3=Rossi|first3=Andrea|last4=Garre|first4=Maria L.|last5=Cama|first5=Armando|last6=Koelblinger|first6=Claus|last7=Osborn|first7=Anne G.|last8=Thurnher|first8=Majda M.|title=Magnetic resonance imaging spectrum of medulloblastoma|journal=Neuroradiology|volume=53|issue=6|year=2011|pages=387–396|issn=0028-3940|doi=10.1007/s00234-010-0829-8}}</ref><ref name="BurgerGrahmann1987">{{cite journal|last1=Burger|first1=P. C.|last2=Grahmann|first2=F. C.|last3=Bliestle|first3=A.|last4=Kleihues|first4=P.|title=Differentiation in the medulloblastoma|journal=Acta Neuropathologica|volume=73|issue=2|year=1987|pages=115–123|issn=0001-6322|doi=10.1007/BF00693776}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |PTEN
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | Hamartomas
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px;" |
* ''PTEN'' mutation probability risk calculator
* [[Infratentorial]]
 
* Mostly in [[cerebellum]]
 
* Non communicating [[hydrocephalus]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Neuroectoderm]] origin
 
* Homer wright rosettes
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Drop metastasis]] ([[metastasis]] through [[CSF]])
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Acromegaly]]/[[gigantism]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ependymoma]]<br><ref name="YuhBarkovich2009">{{cite journal|last1=Yuh|first1=E. L.|last2=Barkovich|first2=A. J.|last3=Gupta|first3=N.|title=Imaging of ependymomas: MRI and CT|journal=Child's Nervous System|volume=25|issue=10|year=2009|pages=1203–1213|issn=0256-7040|doi=10.1007/s00381-009-0878-7}}</ref><ref name=":0" />
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* Enlargement of the [[hand]]s, [[feet]], [[nose]], [[lip]]s and [[ear]]s, and a general thickening of the [[skin]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Hypertrichosis]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* [[Hyperpigmentation]]  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Hyperhidrosis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Carpal tunnel syndrome]].
* [[Infratentorial]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>+</nowiki>
* Usually found in [[Fourth ventricle|4th ventricle]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* Mixed [[Cyst|cystic]]/solid [[lesion]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
 
* An elevated concentration of serum [[Growth hormone|growth hormone (GH)]] and [[Insulin-like growth factor|insulin-like growth factor 1(IGF-1)]] levels is diagnostic of acromegaly.
* Hydrocephalus
| style="background: #F5F5F5; padding: 5px;" |
* [[Ependymal cell]] origin
 
* Peri[[vascular]] pseudorosette
| style="background: #F5F5F5; padding: 5px;" |
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Causes an unusually persistent, continuous [[headache]] in children.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pituitary adenoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Craniopharyngioma]]<br><ref name="pmid12407316">{{cite journal |vauthors=Brunel H, Raybaud C, Peretti-Viton P, Lena G, Girard N, Paz-Paredes A, Levrier O, Farnarier P, Manera L, Choux M |title=[Craniopharyngioma in children: MRI study of 43 cases] |language=French |journal=Neurochirurgie |volume=48 |issue=4 |pages=309–18 |date=September 2002 |pmid=12407316 |doi= |url=}}</ref><ref name="PrabhuBrown2005">{{cite journal|last1=Prabhu|first1=Vikram C.|last2=Brown|first2=Henry G.|title=The pathogenesis of craniopharyngiomas|journal=Child's Nervous System|volume=21|issue=8-9|year=2005|pages=622–627|issn=0256-7040|doi=10.1007/s00381-005-1190-9}}</ref><ref name="pmid766825">{{cite journal |vauthors=Kennedy HB, Smith RJ |title=Eye signs in craniopharyngioma |journal=Br J Ophthalmol |volume=59 |issue=12 |pages=689–95 |date=December 1975 |pmid=766825 |pmc=1017436 |doi= |url=}}</ref><ref name=":0" />
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + [[Bitemporal hemianopia]]
* [[Visual field defect]]s classically [[bitemporal hemianopsia]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* Increased [[intracranial pressure]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
* [[Migraine]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Lateral rectus]] palsy
* [[Hypopituitarism]] as a result of pressure effect on [[pituitary gland]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>+</nowiki>
* [[Calcification]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
* Lobulated contour
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
* Motor-oil like fluid within [[tumor]]
:*Elevated serum level of  [[prolactin]]
| style="background: #F5F5F5; padding: 5px;" |
:*Elevated or decreased serum level of  [[adrenocorticotropic hormone]] (ACTH)
* [[Ectoderm|Ectodermal]] origin ([[Rathke's pouch|Rathkes pouch]])
:*Elevated or decreased serum level of  [[growth hormone]] (GH)
 
:*Elevated or decreased serum level of  [[thyroid-stimulating hormone]] (TSH)
* [[Calcification]] +
:*Elevated or decreased serum level of  [[follicle-stimulating hormone]] (FSH)
| style="background: #F5F5F5; padding: 5px;" |
:*Elevated or decreased serum level of  [[luteinizing hormone]] (LH)
* [[Biopsy]]
| style="background: #F5F5F5; padding: 5px;" |
* Initialy presents with lower bitemporal quadrantanopsia followed by [[Bitemporal hemianopia|bitemporal hemianopsia]] (pressure on [[Optic chiasm|optic chiasma]] from above)
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Hyperparathyroidism]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pinealoma]]<br><ref name="pmid6625640">{{cite journal |vauthors=Ahmed SR, Shalet SM, Price DA, Pearson D |title=Human chorionic gonadotrophin secreting pineal germinoma and precocious puberty |journal=Arch. Dis. Child. |volume=58 |issue=9 |pages=743–5 |date=September 1983 |pmid=6625640 |doi= |url=}}</ref><ref name="Sano1976">{{cite journal|last1=Sano|first1=Keiji|title=Pinealoma in Children|journal=Pediatric Neurosurgery|volume=2|issue=1|year=1976|pages=67–72|issn=1016-2291|doi=10.1159/000119602}}</ref><ref name="Baggenstoss1939">{{cite journal|last1=Baggenstoss|first1=Archie H.|title=PINEALOMAS|journal=Archives of Neurology And Psychiatry|volume=41|issue=6|year=1939|pages=1187|issn=0096-6754|doi=10.1001/archneurpsyc.1939.02270180115011}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
* [[Kidney stone]]s
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
* [[Hypercalcemia]],
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + vertical gaze palsy
* [[Constipation]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Peptic ulcer]]s
* B-hCG rise leads to [[precocious puberty]] in [[Male|males]]
* [[Depression]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>+</nowiki>
* [[Hydrocephalus]] (compression of [[cerebral aqueduct]])
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* Similar to [[testicular seminoma]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px;" |
* An elevated concentration of serum [[calcium]] with elevated [[parathyroid hormone]] level is diagnostic of primary hyperparathyroidism.
* [[Biopsy]]
* Most consistent laboratory findings associated with the diagnosis of secondary hyperparathyroidism include elevated serum [[parathyroid hormone]] level and low to normal serum [[calcium]].
| style="background: #F5F5F5; padding: 5px;" |
* An elevated concentration of serum [[calcium]] with elevated [[parathyroid hormone]] level in post [[Kidney transplantation|renal transplant]] patients is diagnostic of tertiary hyperparathyoidism.
* May cause prinaud syndrome ([[Vertical gaze center|vertical gaze]] palsy, pupillary light-near dissociation, lid retraction and convergence-retraction [[nystagmus]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pheochromocytoma]]/[[paraganglioma]]
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Vascular
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation|AV malformation]]<br><ref name="KucharczykLemme-Pleghos1985">{{cite journal|last1=Kucharczyk|first1=W|last2=Lemme-Pleghos|first2=L|last3=Uske|first3=A|last4=Brant-Zawadzki|first4=M|last5=Dooms|first5=G|last6=Norman|first6=D|title=Intracranial vascular malformations: MR and CT imaging.|journal=Radiology|volume=156|issue=2|year=1985|pages=383–389|issn=0033-8419|doi=10.1148/radiology.156.2.4011900}}</ref><ref name="FleetwoodSteinberg2002">{{cite journal|last1=Fleetwood|first1=Ian G|last2=Steinberg|first2=Gary K|title=Arteriovenous malformations|journal=The Lancet|volume=359|issue=9309|year=2002|pages=863–873|issn=01406736|doi=10.1016/S0140-6736(02)07946-1}}</ref><ref name=":0" />
''VHL''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
''RET''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
''NF1''  
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
''SDHB'' 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
''SDHD''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Characterized by
| style="background: #F5F5F5; padding: 5px;" |
* Episodic [[hypertension]]
* [[Supratentorial]]: ~85%
* [[Palpitation]]s
* Flow voids on T2 weighted images
* [[Anxiety]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Diaphoresis]]
* We do not perform [[biopsy]] for [[AVM]]
* [[Weight loss]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* [[Angiography]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* We may see bag of worms appearance in [[CT angiography]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
* Increased catecholamines and metanephrines in plasma (blood) or through a 24-hour urine collection.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Adrenocortical carcinoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain aneurysm]]<br><ref name="ChapmanRubinstein1992">{{cite journal|last1=Chapman|first1=Arlene B.|last2=Rubinstein|first2=David|last3=Hughes|first3=Richard|last4=Stears|first4=John C.|last5=Earnest|first5=Michael P.|last6=Johnson|first6=Ann M.|last7=Gabow|first7=Patricia A.|last8=Kaehny|first8=William D.|title=Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney Disease|journal=New England Journal of Medicine|volume=327|issue=13|year=1992|pages=916–920|issn=0028-4793|doi=10.1056/NEJM199209243271303}}</ref><ref name="pmid25632331">{{cite journal |vauthors=Castori M, Voermans NC |title=Neurological manifestations of Ehlers-Danlos syndrome(s): A review |journal=Iran J Neurol |volume=13 |issue=4 |pages=190–208 |date=October 2014 |pmid=25632331 |pmc=4300794 |doi= |url=}}</ref><ref name="SchievinkRaissi2010">{{cite journal|last1=Schievink|first1=W. I.|last2=Raissi|first2=S. S.|last3=Maya|first3=M. M.|last4=Velebir|first4=A.|title=Screening for intracranial aneurysms in patients with bicuspid aortic valve|journal=Neurology|volume=74|issue=18|year=2010|pages=1430–1433|issn=0028-3878|doi=10.1212/WNL.0b013e3181dc1acf}}</ref><ref name="pmid28486967">{{cite journal |vauthors=Germain DP |title=Pseudoxanthoma elasticum |journal=Orphanet J Rare Dis |volume=12 |issue=1 |pages=85 |date=May 2017 |pmid=28486967 |pmc=5424392 |doi=10.1186/s13023-017-0639-8 |url=}}</ref><ref name="pmid27162847">{{cite journal |vauthors=Farahmand M, Farahangiz S, Yadollahi M |title=Diagnostic Accuracy of Magnetic Resonance Angiography for Detection of Intracranial Aneurysms in Patients with Acute Subarachnoid Hemorrhage; A Comparison to Digital Subtraction Angiography |journal=Bull Emerg Trauma |volume=1 |issue=4 |pages=147–51 |date=October 2013 |pmid=27162847 |pmc=4789449 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
*p53
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
*Retinoblastoma h19
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
*Insulin-like growth factor II (IGF-II)
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
*p57<sup>kip2</sup>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |17p, 13q 
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
| style="background: #F5F5F5; padding: 5px;" |
* [[Cushing syndrome]] ([[cortisol]] hypersecretion)
* In [[magnetic resonance angiography]], we may see [[aneurysm]] mostly in anterior circulation (~85%)
* [[Conn syndrome]] ([[aldosterone]] hypersecretion)
| style="background: #F5F5F5; padding: 5px;" |
* [[virilization]] ([[testosterone]] hypersecretion)
* We do not perform [[biopsy]] for [[brain aneurysm]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
* [[Magnetic resonance angiography]]  and [[CT angiography]] ([[Angiography]] is reserved for patients who have negative [[Magnetic resonance angiography|MAR]] and [[CT angiography|CTA]])
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |<nowiki>-</nowiki>
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
* It is associated with [[autosomal dominant polycystic kidney disease]], [[Ehlers-Danlos syndrome]], [[pseudoxanthoma elasticum]] and [[Bicuspid aortic valve]]
* Increased serum glucose
* Increased urine cortisol
* Serum androstenedione and dehydroepiandrosterone
* Low serum potassium
* Low plasma renin activity
* High serum aldosterone.
* Excess serum estrogen.
|-
|-
| colspan="8" style="padding: 5px 5px; background: #F5F5F5;" |<small>Adapted from Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts, journal=Clinics (Sao Paulo), volume= 68, issue= 7, 07/24/2013<ref name="pmid23917672">{{cite journal| author=Toledo SP, Lourenço DM, Toledo RA| title=A differential diagnosis of inherited endocrine tumors and their tumor counterparts. | journal=Clinics (Sao Paulo) | year= 2013 | volume= 68 | issue= 7 | pages= 1039-56 | pmid=23917672 | doi=10.6061/clinics/2013(07)24 | pmc=PMC3715026 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23917672  }} </ref> </small>
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |Infectious
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Bacterial [[brain abscess]]<br><ref name="HaimesZimmerman1989">{{cite journal|last1=Haimes|first1=AB|last2=Zimmerman|first2=RD|last3=Morgello|first3=S|last4=Weingarten|first4=K|last5=Becker|first5=RD|last6=Jennis|first6=R|last7=Deck|first7=MD|title=MR imaging of brain abscesses|journal=American Journal of Roentgenology|volume=152|issue=5|year=1989|pages=1073–1085|issn=0361-803X|doi=10.2214/ajr.152.5.1073}}</ref><ref name="BrouwerTunkel2014">{{cite journal|last1=Brouwer|first1=Matthijs C.|last2=Tunkel|first2=Allan R.|last3=McKhann|first3=Guy M.|last4=van de Beek|first4=Diederik|title=Brain Abscess|journal=New England Journal of Medicine|volume=371|issue=5|year=2014|pages=447–456|issn=0028-4793|doi=10.1056/NEJMra1301635}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Leukocytosis]]
* Elevated [[ESR]]
* [[Blood culture]] may be positive for underlying [[organism]]
| style="background: #F5F5F5; padding: 5px;" |
* Central hypodense signal and surrounding ring-enhancement in T1
* Central hyperintense area surrounded by a well-defined hypointense capsule with surrounding [[edema]] in T2
| style="background: #F5F5F5; padding: 5px;" |
* We do not perform [[biopsy]] for [[brain abscess]]
| style="background: #F5F5F5; padding: 5px;" |
* Clinical presentation/ imaging
| style="background: #F5F5F5; padding: 5px;" |
* The most common causes of [[brain abscess]] are [[Streptococcus]] and [[Staphylococcus]].
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tuberculosis]]<br><ref name="MorgadoRuivo2005">{{cite journal|last1=Morgado|first1=Carlos|last2=Ruivo|first2=Nuno|title=Imaging meningo-encephalic tuberculosis|journal=European Journal of Radiology|volume=55|issue=2|year=2005|pages=188–192|issn=0720048X|doi=10.1016/j.ejrad.2005.04.017}}</ref><ref name=":0" /><ref name="pmid19275620">{{cite journal |vauthors=Be NA, Kim KS, Bishai WR, Jain SK |title=Pathogenesis of central nervous system tuberculosis |journal=Curr. Mol. Med. |volume=9 |issue=2 |pages=94–9 |date=March 2009 |pmid=19275620 |pmc=4486069 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Positive [[acid-fast bacilli]] ([[AFB]]) smear in [[CSF]] specimen
* Positive [[CSF]] [[nucleic acid]] amplification testing
* [[Hyponatremia]] (inappropriate secretion of [[antidiuretic hormone]])
* Mild [[anemia]]
* [[Leukocytosis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Hydrocephalus]] combined with marked basilar [[Meninges|meningeal]] enhancement
| style="background: #F5F5F5; padding: 5px;" |
* We do not perform [[biopsy]] for [[brain]] [[tuberculosis]]
| style="background: #F5F5F5; padding: 5px;" |
* [[CSF]] analysis/ Imaging
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[HIV]] [[infection]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Toxoplasmosis]]<br><ref name="pmid74807332">{{cite journal |vauthors=Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ |title=Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy |journal=Radiology |volume=197 |issue=3 |pages=649–54 |date=December 1995 |pmid=7480733 |doi=10.1148/radiology.197.3.7480733 |url=}}</ref><ref name="pmid27348541">{{cite journal |vauthors=Helton KJ, Maron G, Mamcarz E, Leventaki V, Patay Z, Sadighi Z |title=Unusual magnetic resonance imaging presentation of post-BMT cerebral toxoplasmosis masquerading as meningoencephalitis and ventriculitis |journal=Bone Marrow Transplant. |volume=51 |issue=11 |pages=1533–1536 |date=November 2016 |pmid=27348541 |doi=10.1038/bmt.2016.168 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Normal [[CSF]]
| style="background: #F5F5F5; padding: 5px;" |
* Multifocal [[Mass|masses]] with ring enhancement
* Mostly in [[basal ganglia]], [[thalami]], and corticomedullary junction.
| style="background: #F5F5F5; padding: 5px;" |
* We do not perform [[biopsy]] for brain [[toxoplasmosis]]
| style="background: #F5F5F5; padding: 5px;" |
* Clinical presentation/ imaging
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[HIV]] [[infection]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hydatid cyst]]<br><ref name="pmid27620198">{{cite journal |vauthors=Taslakian B, Darwish H |title=Intracranial hydatid cyst: imaging findings of a rare disease |journal=BMJ Case Rep |volume=2016 |issue= |pages= |date=September 2016 |pmid=27620198 |pmc=5030532 |doi=10.1136/bcr-2016-216570 |url=}}</ref><ref name=":0" />
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: left;" |
* Positive [[serology]] ([[Antibody]] detection for [[E. granulosus]]'')''
| style="background: #F5F5F5; padding: 5px;" |
* Honeycomb appearance
* [[Necrotic]] area
| style="background: #F5F5F5; padding: 5px;" |
* We do not perform [[biopsy]] for [[Hydatid cyst|hydatid cysts]]
| style="background: #F5F5F5; padding: 5px;" |
* Imaging
| style="background: #F5F5F5; padding: 5px;" |
* [[Brain]], [[eye]], and [[Spleen|splenic]] [[Cyst|cysts]] may not produce detectable amount of [[antibodies]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[CNS]] [[cryptococcosis]]<br><ref name="pmid25006721">{{cite journal |vauthors=McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ |title=Mold infections of the central nervous system |journal=N. Engl. J. Med. |volume=371 |issue=2 |pages=150–60 |date=July 2014 |pmid=25006721 |pmc=4840461 |doi=10.1056/NEJMra1216008 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Positive [[CSF]] [[antigen]] testing ([[coccidioidomycosis]])
* [[CSF]] [[Lymphocyte|lymphocytic]] [[pleocytosis]]
* Elevated [[CSF]] [[Protein|proteins]] and [[lactate]]
* Low [[CSF]] [[glucose]]
*
| style="background: #F5F5F5; padding: 5px;" |
* Dilated peri[[vascular]] spaces
* [[Basal ganglia]] [[Pseudocyst|pseudocysts]]
 
* Soap bubble brain lesions ([[cryptococcus neoformans]])
*
| style="background: #F5F5F5; padding: 5px;" |
* We may see numerous acutely branching septate [[Hypha|hyphae]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Laboratory|Lab]] data/ Imaging
* since [[brain]] [[Biopsy|biopsies]] are highly invasive and may may cause [[neurological]] deficits, we [[diagnose]] [[CNS]] [[fungal]] [[Infection|infections]] based on [[laboratory]] and imaging findings
| style="background: #F5F5F5; padding: 5px;" |
* It is the most common [[brain]] [[fungal infection]]
 
* It is associated with [[HIV]], [[Immunosuppressive therapy|immunosuppressive therapies]], and [[Organ transplant|organ transplants]]
* In may happen in [[immunocompetent]] patients undergoing invasive procedures ( [[neurosurgery]]) or exposed to [[Contamination|contaminated]] devices or [[drugs]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[CNS]] [[aspergillosis]]<br><ref name="pmid250067212">{{cite journal |vauthors=McCarthy M, Rosengart A, Schuetz AN, Kontoyiannis DP, Walsh TJ |title=Mold infections of the central nervous system |journal=N. Engl. J. Med. |volume=371 |issue=2 |pages=150–60 |date=July 2014 |pmid=25006721 |pmc=4840461 |doi=10.1056/NEJMra1216008 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |
* Positive [[galactomannan]] [[antigen]] testing ([[aspergillosis]])
* [[CSF]] [[Lymphocyte|lymphocytic]] [[pleocytosis]]
* Elevated [[CSF]] [[Protein|proteins]] and [[lactate]]
* Low [[CSF]] [[glucose]]
| style="background: #F5F5F5; padding: 5px;" |
* Multiple [[Abscess|abscesses]]
* Ring enhancement
* Peripheral low signal intensity on T2
| style="background: #F5F5F5; padding: 5px;" |
* We may see numerous acutely branching septate [[Hypha|hyphae]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Laboratory|Lab]] data/ Imaging
* since [[brain]] [[Biopsy|biopsies]] are highly invasive and may may cause [[neurological]] deficits, we [[diagnose]] [[CNS]] [[fungal]] [[Infection|infections]] based on [[laboratory]] and imaging findings
| style="background: #F5F5F5; padding: 5px;" |
* It is associated with [[HIV]], [[Immunosuppressive therapy|immunosuppressive therapies]], and [[Organ transplant|organ transplants]]
* In may happen in [[immunocompetent]] patients undergoing invasive procedures ( [[neurosurgery]]) or exposed to [[Contamination|contaminated]] devices or [[drugs]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Other
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain metastasis]]<br><ref name="pmid29307364">{{cite journal |vauthors=Pope WB |title=Brain metastases: neuroimaging |journal=Handb Clin Neurol |volume=149 |issue= |pages=89–112 |date=2018 |pmid=29307364 |pmc=6118134 |doi=10.1016/B978-0-12-811161-1.00007-4 |url=}}</ref><ref name=":0" />
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/−
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px; text-align: center;" | −
| style="background: #F5F5F5; padding: 5px;" |
* Multiple [[Lesion|lesions]]
* [[Vasogenic edema]]
*
| style="background: #F5F5F5; padding: 5px;" |
* Based on the primary [[cancer]] type we may have different immunohistopathology findings.
| style="background: #F5F5F5; padding: 5px;" |
* History/ imaging
* If there is any uncertainty about [[etiology]], [[biopsy]] should be performed
| style="background: #F5F5F5; padding: 5px;" |
* Most common primary [[Tumor|tumors]] that [[metastasis]] to [[brain]]:
** [[Lung cancer]]
** [[Renal cell carcinoma]]
** [[Breast cancer]]
** [[Melanoma]]
** [[Gastrointestinal tract]]
|}
|}
</small>
'''ABBREVIATIONS'''
 
CNS=Central nervous system, AV=Arteriovenous, CSF=Cerebrospinal fluid, NF-2=Neurofibromatosis type 2, MEN-1=Multiple endocrine neoplasia, GFAP=Glial fibrillary acidic protein, HIV=Human immunodeficiency virus, BhCG=Human chorionic gonadotropin, ESR=Erythrocyte sedimentation rate, AFB=Acid fast bacilli


==References==
==References==
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Revision as of 17:59, 30 January 2019

Pituitary adenoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Differential Diagnosis

Differentiating astrocytoma from other diseases on the basis of seizure, visual disturbance, and constitutional symptoms

On the basis of seizure, visual disturbance, and constitutional symptoms, astrocytoma must be differentiated from oligodendroglioma, meningioma, hemangioblastoma, pituitary adenoma, schwannoma, primary CNS lymphoma, medulloblastoma, ependymoma, craniopharyngioma, pinealoma, AV malformation, brain aneurysm, bacterial brain abscess, tuberculosis, toxoplasmosis, hydatid cyst, CNS cryptococcosis, CNS aspergillosis, and brain metastasis.

Diseases Clinical manifestations Para-clinical findings Gold
standard 		Additional findings
Symptoms Physical examination
Lab Findings MRI Immunohistopathology
Head-
ache 		Seizure Visual disturbance Constitutional Focal neurological deficit
Adult primary brain tumors Glioblastoma multiforme
[1][2][3] 		+ +/− +/− − + −
  • Pseudopalisading appearance
oligodendroglioma
[4][5][6] 		+ + +/− − + −
  • Chicken wire capillary pattern
  • Fried egg cell appearance
Meningioma
[7][8][9] 		+ +/− +/− − + −
  • Well circumscribed
  • Extra-axial mass
  • Whorled spindle cell pattern
  • May be associated with NF-2
Hemangioblastoma
[10][11][12][13] 		+ +/− +/− − + −
Pituitary adenoma
[14][15][3] 		− − + Bitemporal hemianopia − −
  • It is associated with MEN1 disease.
Schwannoma
[16][17][18][19] 		− − − − + −
  • Split-fat sign
  • Fascicular sign
  • Often have areas of hemosiderin
  • S100+
Primary CNS lymphoma
[20][21] 		+ +/− +/− − + −
  • Single mass with ring enhancement
Childhood primary brain tumors Pilocytic astrocytoma
[22][23][24] 		+ +/− +/− − + −
Medulloblastoma
[25][26][27] 		+ +/− +/− − + −
  • Homer wright rosettes
Ependymoma
[28][3] 		+ +/− +/− − + −
  • Hydrocephalus
  • Causes an unusually persistent, continuous headache in children.
Craniopharyngioma
[29][30][31][3] 		+ +/− + Bitemporal hemianopia − +
Pinealoma
[32][33][34] 		+ +/− +/− − + vertical gaze palsy
  • May cause prinaud syndrome (vertical gaze palsy, pupillary light-near dissociation, lid retraction and convergence-retraction nystagmus
Vascular AV malformation
[35][36][3] 		+ + +/− − +/− −
Brain aneurysm
[37][38][39][40][41] 		+ +/− +/− − +/− −
Infectious Bacterial brain abscess
[42][43] 		+ +/− +/− + +
  • Central hypodense signal and surrounding ring-enhancement in T1
  • Central hyperintense area surrounded by a well-defined hypointense capsule with surrounding edema in T2
  • Clinical presentation/ imaging
Tuberculosis
[44][3][45] 		+ +/− +/− + +
  • CSF analysis/ Imaging
Toxoplasmosis
[46][47] 		+ +/− +/− − +
  • Clinical presentation/ imaging
Hydatid cyst
[48][3] 		+ +/− +/− +/− +
  • Imaging
CNS cryptococcosis
[49] 		+ +/− +/− + +
  • We may see numerous acutely branching septate hyphae
CNS aspergillosis
[50] 		+ +/− +/− + +
  • Multiple abscesses
  • Ring enhancement
  • Peripheral low signal intensity on T2
  • We may see numerous acutely branching septate hyphae
Other Brain metastasis
[51][3] 		+ +/− +/− + + −
  • Based on the primary cancer type we may have different immunohistopathology findings.
  • History/ imaging
  • If there is any uncertainty about etiology, biopsy should be performed

ABBREVIATIONS

CNS=Central nervous system, AV=Arteriovenous, CSF=Cerebrospinal fluid, NF-2=Neurofibromatosis type 2, MEN-1=Multiple endocrine neoplasia, GFAP=Glial fibrillary acidic protein, HIV=Human immunodeficiency virus, BhCG=Human chorionic gonadotropin, ESR=Erythrocyte sedimentation rate, AFB=Acid fast bacilli

References

  1. ↑ Sathornsumetee S, Rich JN, Reardon DA (November 2007). "Diagnosis and treatment of high-grade astrocytoma". Neurol Clin. 25 (4): 1111–39, x. doi:10.1016/j.ncl.2007.07.004. PMID 17964028.
  2. ↑ Pedersen CL, Romner B (January 2013). "Current treatment of low grade astrocytoma: a review". Clin Neurol Neurosurg. 115 (1): 1–8. doi:10.1016/j.clineuro.2012.07.002. PMID 22819718.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.
  4. ↑ Smits M (2016). "Imaging of oligodendroglioma". Br J Radiol. 89 (1060): 20150857. doi:10.1259/bjr.20150857. PMC 4846213. PMID 26849038.
  5. ↑ Wesseling P, van den Bent M, Perry A (June 2015). "Oligodendroglioma: pathology, molecular mechanisms and markers". Acta Neuropathol. 129 (6): 809–27. doi:10.1007/s00401-015-1424-1. PMC 4436696. PMID 25943885.
  6. ↑ Kerkhof M, Benit C, Duran-Pena A, Vecht CJ (2015). "Seizures in oligodendroglial tumors". CNS Oncol. 4 (5): 347–56. doi:10.2217/cns.15.29. PMC 6082346. PMID 26478444.
  7. ↑ Zee CS, Chin T, Segall HD, Destian S, Ahmadi J (June 1992). "Magnetic resonance imaging of meningiomas". Semin. Ultrasound CT MR. 13 (3): 154–69. PMID 1642904.
  8. ↑ Shibuya M (2015). "Pathology and molecular genetics of meningioma: recent advances". Neurol. Med. Chir. (Tokyo). 55 (1): 14–27. doi:10.2176/nmc.ra.2014-0233. PMID 25744347.
  9. ↑ Begnami MD, Palau M, Rushing EJ, Santi M, Quezado M (September 2007). "Evaluation of NF2 gene deletion in sporadic schwannomas, meningiomas, and ependymomas by chromogenic in situ hybridization". Hum. Pathol. 38 (9): 1345–50. doi:10.1016/j.humpath.2007.01.027. PMC 2094208. PMID 17509660.
  10. ↑ Lonser RR, Butman JA, Huntoon K, Asthagiri AR, Wu T, Bakhtian KD, Chew EY, Zhuang Z, Linehan WM, Oldfield EH (May 2014). "Prospective natural history study of central nervous system hemangioblastomas in von Hippel-Lindau disease". J. Neurosurg. 120 (5): 1055–62. doi:10.3171/2014.1.JNS131431. PMC 4762041. PMID 24579662.
  11. ↑ Hussein MR (October 2007). "Central nervous system capillary haemangioblastoma: the pathologist's viewpoint". Int J Exp Pathol. 88 (5): 311–24. doi:10.1111/j.1365-2613.2007.00535.x. PMC 2517334. PMID 17877533.
  12. ↑ Lee SR, Sanches J, Mark AS, Dillon WP, Norman D, Newton TH (May 1989). "Posterior fossa hemangioblastomas: MR imaging". Radiology. 171 (2): 463–8. doi:10.1148/radiology.171.2.2704812. PMID 2704812.
  13. ↑ Perks WH, Cross JN, Sivapragasam S, Johnson P (March 1976). "Supratentorial haemangioblastoma with polycythaemia". J. Neurol. Neurosurg. Psychiatry. 39 (3): 218–20. PMID 945331.
  14. ↑ Kucharczyk W, Davis DO, Kelly WM, Sze G, Norman D, Newton TH (December 1986). "Pituitary adenomas: high-resolution MR imaging at 1.5 T". Radiology. 161 (3): 761–5. doi:10.1148/radiology.161.3.3786729. PMID 3786729.
  15. ↑ Syro LV, Scheithauer BW, Kovacs K, Toledo RA, Londoño FJ, Ortiz LD, Rotondo F, Horvath E, Uribe H (2012). "Pituitary tumors in patients with MEN1 syndrome". Clinics (Sao Paulo). 67 Suppl 1: 43–8. PMC 3328811. PMID 22584705.
  16. ↑ Donnelly, Martin J.; Daly, Carmel A.; Briggs, Robert J. S. (2007). "MR imaging features of an intracochlear acoustic schwannoma". The Journal of Laryngology & Otology. 108 (12). doi:10.1017/S0022215100129056. ISSN 0022-2151.
  17. ↑ Feany MB, Anthony DC, Fletcher CD (May 1998). "Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge". Histopathology. 32 (5): 405–10. PMID 9639114.
  18. ↑ Chen H, Xue L, Wang H, Wang Z, Wu H (July 2017). "Differential NF2 Gene Status in Sporadic Vestibular Schwannomas and its Prognostic Impact on Tumour Growth Patterns". Sci Rep. 7 (1): 5470. doi:10.1038/s41598-017-05769-0. PMID 28710469.
  19. ↑ Hardell, Lennart; Hansson Mild, Kjell; Sandström, Monica; Carlberg, Michael; Hallquist, Arne; Påhlson, Anneli (2003). "Vestibular Schwannoma, Tinnitus and Cellular Telephones". Neuroepidemiology. 22 (2): 124–129. doi:10.1159/000068745. ISSN 0251-5350.
  20. ↑ Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ (December 1995). "Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy". Radiology. 197 (3): 649–54. doi:10.1148/radiology.197.3.7480733. PMID 7480733.
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  44. ↑ Morgado, Carlos; Ruivo, Nuno (2005). "Imaging meningo-encephalic tuberculosis". European Journal of Radiology. 55 (2): 188–192. doi:10.1016/j.ejrad.2005.04.017. ISSN 0720-048X.
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  46. ↑ Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Miller RF, Kendall BE, Newman SP, Harrison MJ (December 1995). "Toxoplasmosis and primary central nervous system lymphoma in HIV infection: diagnosis with MR spectroscopy". Radiology. 197 (3): 649–54. doi:10.1148/radiology.197.3.7480733. PMID 7480733.
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  51. ↑ Pope WB (2018). "Brain metastases: neuroimaging". Handb Clin Neurol. 149: 89–112. doi:10.1016/B978-0-12-811161-1.00007-4. PMC 6118134. PMID 29307364.

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