Type:
Educational Exhibit
Keywords:
Neoplasia, Education and training, Cancer, Education, MR, CT, Oncology, Neuroradiology brain, CNS
Authors:
C. Calles Blanco1, J. A. Guzman de Villoria2; 1Madrid/ES, 2Madrid, Ma/ES
DOI:
10.1594/ecr2013/C-0937
Conclusion
The differential diagnosis for pineal region lesions includes basically germ cell neoplasms and pineal cell neoplasms.
Germinoma and pineoblastoma,
have high attenuation at CT due to their high cellularity,
but if pineal calcification is seen the germinoma will tend to engulf it,
whereas in pineoblastomas it will be exploded to the periphery.
The presence of lipid or fat attenuation at CT leads to the differential diagnosis of a teratoma,
or lipoma.
Intrinsic increased T1 signal intensity may be seen in pineal parenchymal neoplasms or GCTs with hemorrhage,
and in lipomas or teratomas.
Use of fat saturation and gradient-echo sequences can help differentiate these lesions.
None of these tumors have a truly pathognomonic imaging pattern.
Therefore histologic verification is necessary for almost every pineal region mass that appears to be neoplasic.
Knowledge of the various imaging findings and use of CSF and serum laboratory studies will help narrow the differential diagnosis for pineal region neoplasms.