Recent advances in the understanding of the genetic makeup of gliomas have led to a paradigm shift in the diagnosis and classification of these tumors. Driven by these changes, the World Health Organization (WHO) introduced an update to its classification system of central nervous system (CNS) tumors in 2016. The updated glioma classification system incorporates molecular markers into tumor subgrouping, which has been shown to better correlate with tumor biology and behavior as well as patient prognosis than the previous purely histology-based classification system. Familiarity with this new classification scheme, the individual molecular markers, and corresponding imaging findings is critical for the radiologists who play an important role in diagnostic and surveillance imaging of patients with CNS tumors. The goals of this article are to review these updates to the WHO classification of CNS tumors with a focus on adult gliomas, provide an overview of key genomic markers of gliomas, and review imaging features pertaining to various genomic subgroups of adult gliomas.
Understanding oral cavity and oropharyngeal anatomy is important to identify various pathologies that may afflict them. This article reviews normal magnetic resonance imaging anatomy of these vital spaces and structures, with special attention to the complex musculature, mucosal surfaces, relevant osseous structures, salivary glands, and nerves. Anatomic awareness of these spaces and critical potential pathways for perineural tumoral spread are important to recognize to improve diagnostic evaluation and treatment.
We describe the case of a 50-year-old man with history of remote splenectomy who underwent routine lung cancer screening chest computed tomography and was incidentally found to have a liver lesion. Dedicated liver protocol computed tomography demonstrated "archiform" enhancement pattern in the arterial phase and homogenous filling-in enhancement on portal venous and delayed phases. Multiple other smaller enhancing intraperitoneal lesions were also found. These findings along with history of splenectomy confirmed a diagnosis of intrahepatic and intraperitoneal splenosis and helped avoid biopsy. Intrahepatic splenules can be challenging to diagnose owing to its unusual location and similarity in appearance to a liver neoplasm or metastasis. However, careful evaluation of enhancement pattern and review of medical history can lead to an accurate diagnosis and avoidance of invasive biopsy.
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