Cerebral Blastomycosis: Radiologic-Pathologic Correlation of Solitary CNS Blastomycosis Mass-Like Infection

Blastomycosis is a fungal infection rarely seen in clinical practice. Endemic to the Midwestern United States as well as the Canadian provinces of Manitoba and Ontario, Blastomyces dermatitidis characteristically involves the skin and lungs. Central nervous system (CNS) involvement, although a rare complication of this disease, can be fatal. The current literature on CNS blastomycosis primarily centers on the spectrum of traditional imaging features of T1- and T2-weighted imaging with which this entity can present. However, here we present the direct histopathologic correlation of the imaging findings of solitary mass like CNS blastomycosis, with an emphasis on the association of diffusion restriction within the lesion with a granulomatous immune response.

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Imaging of CNS Fungal Infections: Review Article

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.12241 ◽

2021 ◽

Vol 104 (5) ◽

pp. 872-885

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Central Nervous System ◽

Nervous System ◽

Magnetic Resonance ◽

Fungal Infections ◽

Imaging Features ◽

Imaging Findings ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri

Fungal infections of the central nervous system (CNS) are usually identified in immunocompromised patients but rare in immunocompetent hosts. The clinical and imaging manifestations are mainly influenced by types of fungal pathogen and immune status of the patients. The CNS fungal infections can develop through hematogenous dissemination from primary site of infection, cerebrospinal fluid seeding, or direct extension from adjacent sources of infection. Fungal infections can result in meningitis, meningoencephalitis, cerebritis, granuloma, or abscess formation, which imaging findings are often non-specific and difficult to distinguish from bacterial or tuberculous infection, non-infectious inflammatory disease, or even intracranial neoplasm. Vascular complications including vasculitis, cerebral infarction, or mycotic aneurysm are commonly present due to angioinvasion of fungal hyphae. In addition, some characteristic imaging features of fungal infections can be identified by computed tomography (CT) or magnetic resonance imaging (MRI), such as intracavitary projections in fungal abscesses and gelatinous pseudocysts in cryptococcosis that could help suggest the diagnosis. Recognizing the imaging findings of common intracranial fungal infections combined with appropriate clinical setting is crucial for allowing early diagnosis and leading to early specific treatment. The present article reviewed common imaging findings of CNS fungal infections and distinct imaging features of specific pathogens. Keywords: Fungal infection, Brain abscess, Cryptococcosis, Central nervous system (CNS), Computed tomography (CT), Diffusion weighted imaging (DWI), Magnetic resonance imaging (MRI)

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Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents

Case Reports in Pediatrics ◽

10.1155/2017/5483543 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Iliyana H. Pacheva ◽

Ivan S. Ivanov ◽

Krastina Stefanova ◽

Elena Chepisheva ◽

Lyubov Chochkova ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Arterial Hypertension ◽

Rare Complication ◽

Central Nervous System Involvement ◽

Henoch Schonlein Purpura ◽

Cns Involvement ◽

Hyperintense Lesion ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009–2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0.9%) had CNS involvement presenting as Posterior Reversible Encephalopathy Syndrome (PRES), which may be a result of CNS vasculitis or arterial hypertension. It was an 8-year-old girl with atypical HSP which started with abdominal pain requiring surgery. On the third day after the operation a transient macular rash and arterial hypertension appeared, followed by visual disturbances, hemiconvulsive epileptic seizures, postictal hemiparesis, and confusion. Head CT showed occipital hypodense lesions and MRT-T2 hyperintense lesion in the left occipital lobe. The patient experienced a second similar episode after 2 weeks when palpable purpura had also appeared. Neurological symptoms and MRI resolved completely. HSP can be an etiological factor for PRES in childhood. Although PRES is a rare complication of HSP, clinicians must be aware of it and avoid diagnostic and therapeutic delays.

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Extrapulmonary Tuberculosis: Imaging Features beyond the Chest

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2012.07.002 ◽

2013 ◽

Vol 64 (4) ◽

pp. 319-324 ◽

Cited By ~ 11

Author(s):

Kelly A. MacLean ◽

Annalisa K. Becker ◽

Silvia D. Chang ◽

Alison C. Harris

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Extrapulmonary Tuberculosis ◽

Imaging Features ◽

Imaging Findings ◽

Diagnostic Challenge ◽

Pictorial Review ◽

Breast Tuberculosis ◽

High Risk Populations ◽

High Index Of Suspicion

The purpose of this pictorial review is to illustrate the various imaging findings of extrapulmonary tuberculosis. Manifestations of cardiac, central nervous system, head and neck, musculoskeletal, abdominal, genitourinary, and breast tuberculosis will be discussed. Extrapulmonary tuberculosis presents a difficult diagnostic challenge for the radiologist and requires a high index of suspicion, particularly in high-risk populations.

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Spectrum of developmental anomalies of the central nervous system encountered in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183260 ◽

2018 ◽

Vol 6 (8) ◽

pp. 2732

Author(s):

Subhasish Panda ◽

Subhashree Dash ◽

Savitri Bhagat ◽

Braja Bihari Panda

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Congenital Anomalies ◽

Care Hospital ◽

Imaging Features ◽

Imaging Findings ◽

Developmental Anomalies ◽

The Central Nervous System ◽

One Year ◽

Cns Anomalies

Background: Congenital Central Nervous System (CNS) anomalies have typical and characteristic imaging features. Imaging plays a pivotal role in their diagnosis. This study aims to determine the prevalence and spectrum of the various congenital anomalies of the CNS diagnosed at our institution, and to classify the imaging features according to an approved classification system.Methods: This cross-sectional study was conducted on infants and children below 12 years of age attending the Department of Radiodiagnosis of our Institution, for radiographic investigation of congenital anomalies in CNS through Computerised Tomography and/or Magnetic Resonance Imaging, over a period of one year. The spectrum of imaging features was analysed as per approved classification and corroboration with their clinical background. The prevalence of each type of congenital anomaly was also assessed.Results: A total number of 43 developmental anomalies of the central nervous system were encountered in 33 patients over a period of one year. The most common anomalies encountered were partial corpus callosal agenesis, heterotopic grey matter and Dandy Walker malformation. The total prevalence of CNS anomalies was 4.22%. The most common clinical symptoms in these patients were seizures followed by focal neurological deficit. The imaging findings of each anomaly are discussed.Conclusions: Developmental anomalies of CNS are encountered in 4.22% of patients in our Institution, with partial corpus callosum agenesis being the most frequent entity. Familiarity with imaging findings of these malformations is mandatory for every radiologist.

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Role of Positron Emission Tomography for Central Nervous System Involvement in Systemic Autoimmune Diseases: Status and Perspectives

Current Medicinal Chemistry ◽

10.2174/0929867324666170523144402 ◽

2018 ◽

Vol 25 (26) ◽

pp. 3096-3104 ◽

Cited By ~ 3

Author(s):

Daniele Mauro ◽

Gaetano Barbagallo ◽

Salvatore D`Angelo ◽

Pasqualina Sannino ◽

Saverio Naty ◽

...

Keyword(s):

Positron Emission Tomography ◽

Central Nervous System ◽

Nervous System ◽

Autoimmune Diseases ◽

Pet Imaging ◽

Emission Tomography ◽

Cns Involvement ◽

Systemic Autoimmune Diseases ◽

Positron Emission

In the last years, an increasing interest in molecular imaging has been raised by the extending potential of positron emission tomography [PET]. The role of PET imaging, originally confined to the oncology setting, is continuously extending thanks to the development of novel radiopharmaceutical and to the implementation of hybrid imaging techniques, where PET scans are combined with computed tomography [CT] or magnetic resonance imaging[MRI] in order to improve spatial resolution. Early preclinical studies suggested that 18F–FDG PET can detect neuroinflammation; new developing radiopharmaceuticals targeting more specifically inflammation-related molecules are moving in this direction. Neurological involvement is a distinct feature of various systemic autoimmune diseases, i.e. Systemic Lupus Erythematosus [SLE] or Behcet’s disease [BD]. Although MRI is largely considered the gold-standard imaging technique for the detection of Central Nervous System [CNS] involvement in these disorders. Several patients complain of neuropsychiatric symptoms [headache, epilepsy, anxiety or depression] in the absence of any significant MRI finding; in such patients the diagnosis relies mainly on clinical examination and often the role of the disease process versus iatrogenic or reactive forms is doubtful. The aim of this review is to explore the state-of-the-art for the role of PET imaging in CNS involvement in systemic rheumatic diseases. In addition, we explore the potential role of emerging radiopharmaceutical and their possible application in aiding the diagnosis of CNS involvement in systemic autoimmune diseases.

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A novel gene signature based on five immune checkpoint genes predicts the survival of glioma

Chinese Neurosurgical Journal ◽

10.1186/s41016-020-00220-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Wei Zhang ◽

You Zhai ◽

Guanzhang Li ◽

Tao Jiang

Keyword(s):

Gene Expression ◽

Central Nervous System ◽

Immune Response ◽

Nervous System ◽

Cox Regression ◽

Gene Signature ◽

Immune Checkpoints ◽

The Novel ◽

The Central Nervous System ◽

Checkpoint Genes

Abstract Background Glioma is the most common and fatal type of nerve neoplasm in the central nervous system. Several biomarkers have been considered for prognosis prediction, which is not accurate enough. We aimed to carry out a gene signature related to the expression of immune checkpoints which was enough for its performance in prediction. Methods Gene expression of immune checkpoints in TGGA database was filtrated. The 5 selected genes underwent verification by COX and Lasso-COX regression. Next, the selected genes were included to build a novel signature for further analysis. Results Patients were sub-grouped into high and low risk according to the novel signature. Immune response, clinicopathologic characters, and survival showed significant differences between those 2 groups. Terms including “naive,” “effector,” and “IL-4” were screened out by GSEA. The results showed strong relevance between the signature and immune response. Conclusions We constructed a gene signature with 5 immune checkpoints. The signature predicted survival effectively. The novel signature performed more functional than previous biomarkers.

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Treatment of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy: a single-center study

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00238-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yuchen Wu ◽

Xuefei Sun ◽

Xueyan Bai ◽

Jun Qian ◽

Hong Zhu ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Involvement ◽

Central Nervous System Lymphoma ◽

Progression Free Survival ◽

B Cell Lymphoma ◽

High Dose ◽

Cns Involvement ◽

The Central Nervous System ◽

Secondary Central Nervous System

Abstract Background Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined. Methods We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients. Results Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0–44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%). Conclusions These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.

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CENTRAL NERVOUS SYSTEM INVOLVEMENT IN ADULT ACUTE LYMPHOBLASTIC LEUKEMIA: DIAGNOSTIC TOOLS, PROPHYLAXIS AND THERAPY

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2014.075 ◽

2014 ◽

Vol 6 (1) ◽

pp. e2014075 ◽

Cited By ~ 22

Author(s):

Maria Ilaria Del Principe ◽

Luca Maurillo ◽

Francesco Buccisano ◽

Giuseppe Sconocchia ◽

Mariagiovanna Cefalo ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Intrathecal Injection ◽

False Negative ◽

Diagnostic Tools ◽

Positive Finding ◽

Cns Involvement ◽

Hematopoietic Stem

In adult patients with acute lymphoblastic leukemia (ALL), Central Nervous System (CNS) involvement is associated with a very poor prognosis. The diagnostic assessment of this condition relies on the use of neuroradiology, conventional cytology (CC) and flow cytometry (FCM). Among these approaches, which is the gold standard it is still a matter of debate. Neuroradiology and CC have a limited sensitivity with a higher rate of false negative results. FCM demonstrated a superior sensitivity over CC, particularly when low levels of CNS infiltrating cells are present. Although prospective studies of large series of patients are still awaited, a positive finding by FCM appears to anticipate an adverse outcome even if CC shows no infiltration. Current strategies for adult ALL CNS-directed prophylaxis or therapy involve systemic and intrathecal chemotherapy and radiation therapy. Actually, early and frequent intrathecal injection of cytostatic combined with systemic chemotherapy is the most effective strategy to reduce the frequency of CNS involvement. In patients with CNS overt ALL, at diagnosis or upon relapse, allogenic hematopoietic stem cell transplantation might be considered. This review will discuss risk factors, diagnostic techniques for identification of CNS infiltration and modalities of prophylaxis and therapy to manage it.

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