Langerhans cell histiocytosis(LCH)is a rare proliferative histiocyte disorder.It can affect any organ or system,especially the bone,skin,lung,and central nervous system(CNS).In the CNS,the hypothalamic-pituitary is pr...Langerhans cell histiocytosis(LCH)is a rare proliferative histiocyte disorder.It can affect any organ or system,especially the bone,skin,lung,and central nervous system(CNS).In the CNS,the hypothalamic-pituitary is predominantly affected,whereas the brain parenchyma is rarely affected.LCH occurring in the brain parenchyma can be easily confused with glioblastoma or brain metastases.Thus,multimodal imaging is useful for the differential diagnosis of these intracerebral lesions and detection of lesions in the other organs.CASE SUMMARY A 47-year-old man presented with a headache for one week and sudden syncope.Brain computed tomography(CT)and magnetic resonance imaging showed an irregularly shaped nodule with heterogeneous enhancement.On^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/CT,a nodule with^(18)F-FDG uptake and multiple cysts in the upper lobes of both lungs were noted,which was also confirmed by high-resolution CT.Thus,the patient underwent surgical resection of the brain lesion for further examination.Postoperative pathology confirmed LCH.The patient received chemotherapy after surgery.No recurrence was observed in the brain at the 12-mo follow-up.CONCLUSION Multimodal imaging is useful for evaluating the systemic condition of LCH,developing treatment plans,and designing post-treatment strategies.展开更多
BACKGROUND Enteropathy-associated T cell lymphoma(EATL)is an aggressive intestinal T cell lymphoma derived from intraepithelial lymphocytes,which occurs in individuals with celiac disease(CD).Cerebral involvement is a...BACKGROUND Enteropathy-associated T cell lymphoma(EATL)is an aggressive intestinal T cell lymphoma derived from intraepithelial lymphocytes,which occurs in individuals with celiac disease(CD).Cerebral involvement is an extremely rare condition and as described so far,lymphoma lesions may present as parenchymal predominantly supratentorial or leptomeningeal involvement.We describe a case of EATL with multifocal supra-and infratentorial brain involvement in a patient with refractory celiac disease(RCD).CASE SUMMARY A 58-years old man with known CD developed ulcerative jejunitis and was diagnosed with RCD type II.Six months later he presented with subacute cerebellar symptoms(gait ataxia,double vision,dizziness).Cranial magnetic resonance imaging(MRI)revealed multifocal T2 hyperintense supra-and infratentorial lesions.Laboratory studies of blood and cerebrospinal fluid were inconspicuous for infectious,inflammatory or autoimmune diseases.18Ffluorodeoxyglucose-positron emission tomography/computed tomography(18FDG-PET/CT)scan showed a suspect hypermetabolic lesion in the left upper abdomen and consequent surgical jejunal resection revealed the diagnosis of EATL.During the diagnostic work-up,neurological symptoms aggravated and evolved refractory to high-dosage cortisone.Recurrent MRI scans showed progressive cerebral lesions,highly suspicious for lymphoma and methotrexate chemotherapy was initiated.Unfortunately,clinically the patient responded only transiently.Finally,cerebral biopsy confirmed the diagnosis of cerebral involvement of EATL.Considering the poor prognosis and deterioration of the performance status,best supportive care was started.The patient passed away three weeks after diagnosis.CONCLUSION EATL with cerebral involvement must be considered as a possible differential diagnosis in patients with known RCD presenting with neurological symptoms.展开更多
Objective To develop and test an image fusion software(fDf,fMRI/DTI fusion) which can overlap the anatomical(T1WI images),functional MRI(fMRI) and diffusion tensor imaging(DTI) simultaneously for preoperational evalua...Objective To develop and test an image fusion software(fDf,fMRI/DTI fusion) which can overlap the anatomical(T1WI images),functional MRI(fMRI) and diffusion tensor imaging(DTI) simultaneously for preoperational evaluation of patients′ tumor.Methods fMRI with bilateral hands grasp movement and DTI were performed using GE 1.5 T magnetic resonance system on 10 subjects(5 healthy volunteers and 5 patients with brain tumor,of which 3 were metastases,1 was cavernous hemangioma and 1 was glioma).All data were input to the personal computer and offline postprocessing of fMRI and DTI data was performed using SPM5 and VolumeOne software package to visualize the activated functional cortex areas and corticospinal tracts.fDf was used to import the fMRI and structural images to VolumeOne to show them simultaneously.Results Brain functional activation maps and diffusion tensor fiber tracking images were obtained in all five healthy volunteers and four patients except one who suffered from left hemiplegia.The functional activation maps and the fiber tracking images were successfully fused by the fDf software,where the activations areas and the white matter fiber were displayed together.The fusion images of healthy volunteers showed the hand motion areas and corresponding corticospinal tracts,while that of the patients display the relationship of the eloquent cortex and peritumoral fiber tracts,which were useful in guiding the treatments for the surgeons and radiotherapists.It only took hours to present the fused images to the neurosurgeons or the radiotherapists.Conclusions All the results confirm that the image fusion software work well for all the data.It is an easy,free and fast way to realize the image fusion.The neurosurgeon and radiotherapist consider the software were very helpful for preoperative planning.展开更多
基金Supported by Guangdong Medical Research Fund to Han-Xiang Liang,No.B2021084Traditional Chinese Medicine Bureau of Guangdong Province to En-Tao Liu,No.20211005High-level Hospital Construction Research Project of Maoming People's Hospital to Han-Xiang Liang,No.ZX2020014.
文摘Langerhans cell histiocytosis(LCH)is a rare proliferative histiocyte disorder.It can affect any organ or system,especially the bone,skin,lung,and central nervous system(CNS).In the CNS,the hypothalamic-pituitary is predominantly affected,whereas the brain parenchyma is rarely affected.LCH occurring in the brain parenchyma can be easily confused with glioblastoma or brain metastases.Thus,multimodal imaging is useful for the differential diagnosis of these intracerebral lesions and detection of lesions in the other organs.CASE SUMMARY A 47-year-old man presented with a headache for one week and sudden syncope.Brain computed tomography(CT)and magnetic resonance imaging showed an irregularly shaped nodule with heterogeneous enhancement.On^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/CT,a nodule with^(18)F-FDG uptake and multiple cysts in the upper lobes of both lungs were noted,which was also confirmed by high-resolution CT.Thus,the patient underwent surgical resection of the brain lesion for further examination.Postoperative pathology confirmed LCH.The patient received chemotherapy after surgery.No recurrence was observed in the brain at the 12-mo follow-up.CONCLUSION Multimodal imaging is useful for evaluating the systemic condition of LCH,developing treatment plans,and designing post-treatment strategies.
文摘BACKGROUND Enteropathy-associated T cell lymphoma(EATL)is an aggressive intestinal T cell lymphoma derived from intraepithelial lymphocytes,which occurs in individuals with celiac disease(CD).Cerebral involvement is an extremely rare condition and as described so far,lymphoma lesions may present as parenchymal predominantly supratentorial or leptomeningeal involvement.We describe a case of EATL with multifocal supra-and infratentorial brain involvement in a patient with refractory celiac disease(RCD).CASE SUMMARY A 58-years old man with known CD developed ulcerative jejunitis and was diagnosed with RCD type II.Six months later he presented with subacute cerebellar symptoms(gait ataxia,double vision,dizziness).Cranial magnetic resonance imaging(MRI)revealed multifocal T2 hyperintense supra-and infratentorial lesions.Laboratory studies of blood and cerebrospinal fluid were inconspicuous for infectious,inflammatory or autoimmune diseases.18Ffluorodeoxyglucose-positron emission tomography/computed tomography(18FDG-PET/CT)scan showed a suspect hypermetabolic lesion in the left upper abdomen and consequent surgical jejunal resection revealed the diagnosis of EATL.During the diagnostic work-up,neurological symptoms aggravated and evolved refractory to high-dosage cortisone.Recurrent MRI scans showed progressive cerebral lesions,highly suspicious for lymphoma and methotrexate chemotherapy was initiated.Unfortunately,clinically the patient responded only transiently.Finally,cerebral biopsy confirmed the diagnosis of cerebral involvement of EATL.Considering the poor prognosis and deterioration of the performance status,best supportive care was started.The patient passed away three weeks after diagnosis.CONCLUSION EATL with cerebral involvement must be considered as a possible differential diagnosis in patients with known RCD presenting with neurological symptoms.
文摘Objective To develop and test an image fusion software(fDf,fMRI/DTI fusion) which can overlap the anatomical(T1WI images),functional MRI(fMRI) and diffusion tensor imaging(DTI) simultaneously for preoperational evaluation of patients′ tumor.Methods fMRI with bilateral hands grasp movement and DTI were performed using GE 1.5 T magnetic resonance system on 10 subjects(5 healthy volunteers and 5 patients with brain tumor,of which 3 were metastases,1 was cavernous hemangioma and 1 was glioma).All data were input to the personal computer and offline postprocessing of fMRI and DTI data was performed using SPM5 and VolumeOne software package to visualize the activated functional cortex areas and corticospinal tracts.fDf was used to import the fMRI and structural images to VolumeOne to show them simultaneously.Results Brain functional activation maps and diffusion tensor fiber tracking images were obtained in all five healthy volunteers and four patients except one who suffered from left hemiplegia.The functional activation maps and the fiber tracking images were successfully fused by the fDf software,where the activations areas and the white matter fiber were displayed together.The fusion images of healthy volunteers showed the hand motion areas and corresponding corticospinal tracts,while that of the patients display the relationship of the eloquent cortex and peritumoral fiber tracts,which were useful in guiding the treatments for the surgeons and radiotherapists.It only took hours to present the fused images to the neurosurgeons or the radiotherapists.Conclusions All the results confirm that the image fusion software work well for all the data.It is an easy,free and fast way to realize the image fusion.The neurosurgeon and radiotherapist consider the software were very helpful for preoperative planning.
