Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report
Abstract Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimag...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-06-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-021-00522-0 |
| _version_ | 1818588662816833536 |
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| author | Sameer Peer Vivek Murumkar Karthik Kulanthaivelu Chandrajit Prasad Shilpa Rao Vani Santosh |
| author_facet | Sameer Peer Vivek Murumkar Karthik Kulanthaivelu Chandrajit Prasad Shilpa Rao Vani Santosh |
| author_sort | Sameer Peer |
| collection | DOAJ |
| description | Abstract Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimaging with associated communicating hydrocephalus is usually suggestive of infective meningitis and the patients are started on empirical anti-microbial therapy. However, it is important to consider other differential diagnosis of leptomeningeal enhancement in such cases, particularly if the clinical condition does not improve on anti-microbial therapy. An early diagnosis of a neoplastic etiology may be of particular importance as the treatment regimens vary considerably depending on the underlying disease condition. Case presentation In this case report, we describe a case of DLGNT with high-grade histopathological features which was initially managed as tubercular meningitis based on the initial neuroimaging findings. Due to worsening of the clinical course and subsequent imaging findings at follow-up, a diagnosis of DLGNT was considered and subsequently proven to be DLGNT with features of anaplasia on histopathological examination of leptomeningeal biopsy specimen. Conclusion This case highlights the importance of recognizing certain subtle finding on MRI which may help in an early diagnosis of DLGNT which is crucial for appropriate treatment. |
| first_indexed | 2024-12-16T09:28:19Z |
| format | Article |
| id | doaj.art-a1430140fab34f6ea9d23ffedcfc82a2 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-16T09:28:19Z |
| publishDate | 2021-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-a1430140fab34f6ea9d23ffedcfc82a22022-12-21T22:36:37ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622021-06-015211710.1186/s43055-021-00522-0Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case reportSameer Peer0Vivek Murumkar1Karthik Kulanthaivelu2Chandrajit Prasad3Shilpa Rao4Vani Santosh5Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and NeurosciencesDepartment of Neuroimaging and Interventional Radiology, National Institute of Mental Health and NeurosciencesDepartment of Neuroimaging and Interventional Radiology, National Institute of Mental Health and NeurosciencesDepartment of Neuroimaging and Interventional Radiology, National Institute of Mental Health and NeurosciencesDepartment of Neuropathology, National Institute of Mental Health and NeurosciencesDepartment of Neuropathology, National Institute of Mental Health and NeurosciencesAbstract Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimaging with associated communicating hydrocephalus is usually suggestive of infective meningitis and the patients are started on empirical anti-microbial therapy. However, it is important to consider other differential diagnosis of leptomeningeal enhancement in such cases, particularly if the clinical condition does not improve on anti-microbial therapy. An early diagnosis of a neoplastic etiology may be of particular importance as the treatment regimens vary considerably depending on the underlying disease condition. Case presentation In this case report, we describe a case of DLGNT with high-grade histopathological features which was initially managed as tubercular meningitis based on the initial neuroimaging findings. Due to worsening of the clinical course and subsequent imaging findings at follow-up, a diagnosis of DLGNT was considered and subsequently proven to be DLGNT with features of anaplasia on histopathological examination of leptomeningeal biopsy specimen. Conclusion This case highlights the importance of recognizing certain subtle finding on MRI which may help in an early diagnosis of DLGNT which is crucial for appropriate treatment.https://doi.org/10.1186/s43055-021-00522-0Diffuse leptomeningeal glioneuronal tumorEnhancementAnaplasiaMeningitisCase report |
| spellingShingle | Sameer Peer Vivek Murumkar Karthik Kulanthaivelu Chandrajit Prasad Shilpa Rao Vani Santosh Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report The Egyptian Journal of Radiology and Nuclear Medicine Diffuse leptomeningeal glioneuronal tumor Enhancement Anaplasia Meningitis Case report |
| title | Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report |
| title_full | Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report |
| title_fullStr | Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report |
| title_full_unstemmed | Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report |
| title_short | Diffuse leptomeningeal glioneuronal tumor with high-grade features masquerading as tubercular meningitis—a case report |
| title_sort | diffuse leptomeningeal glioneuronal tumor with high grade features masquerading as tubercular meningitis a case report |
| topic | Diffuse leptomeningeal glioneuronal tumor Enhancement Anaplasia Meningitis Case report |
| url | https://doi.org/10.1186/s43055-021-00522-0 |
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