Gliosarcoma demonstrates certain characteristic MR features, such as supratentorial and peripheral location, well-demarcated, abutting a dural surface, uneven and thick-walled rim-like or ring enhancement, as well as intratumoral strip enhancement. These findings, combined with patient age, can aid the differential diagnosis of gliosarcomas from more common primary brain tumors.
SUMMARY:Primary AT/RT is a rare highly malignant tumor of the CNS, usually occurring in children younger than 5 years of age. The objective of this study was to characterize the CT and MR imaging findings in a series of 5 adult patients with pathologically proved AT/RT. All 5 AT/RTs were supratentorial. In 2 patients who underwent nonenhanced CT, the tumors appeared isoattenuated, and 1 of the 2 tumors contained calcifications. Solid portions of the tumors on MR imaging were isointense on T1-weighted, T2-weighted, and FLAIR images, and 1 case showed restricted diffusion on DWI. The tumors also demonstrated a bandlike rim of strong enhancement surrounding a central cystic area on contrast-enhanced T1-weighted imaging. One tumor was associated with destruction of the calvaria. Although AT/RTs can have nonspecific findings, the tumors in our series were large and isointense on T1-weighted, T2-weighted, and FLAIR images with central necrosis and prominent rim enhancement.ABBREVIATIONS: ADC ϭ apparent diffusion coefficient; AT/RT ϭ atypical teratoid/rhabdoid tumor; CNS ϭ central nervous system; DWI ϭ diffusion-weighted imaging; FLAIR ϭ fluid-attenuated inversion recovery; L ϭ left; mRNA ϭ messenger ribonucleic acid; N/A ϭ not available, ND ϭ not depicted; OS ϭ overall survival; PNET ϭ primitive neuroectodermal tumor; PR ϭ partial resection; R ϭ right; TR ϭ total resection A lthough AT/RT was first described as a rare, highly malignant childhood neoplasm of the kidney, it has also been reported at several extrarenal sites including the skin, chest wall, liver, thymus, optic nerve, and the CNS. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] When found in the CNS, it usually arises from the posterior fossa and is most commonly found in children younger than 5 years of age.17 To our knowledge, only 29 cases of primary AT/RT of the CNS in adults have been reported (On-line Table). 18-30The On-line Table summarizes the clinical and imaging data from our patients and from those in the literature.The prognosis of patients with an AT/RT is poor, especially in patients younger than 3 years of age, with a survival time that averages 15 months in children and 38 months in adults. 10,18,19,24 To our knowledge, there are only limited case reports describing the imaging features of this entity in adults. 8,9,18,19,[21][22][23][24][25][26][27][28][29][30][31] The goal of this study was to characterize the CT and MR imaging features of CNS AT/RT in 5 adults. Materials and Methods PatientsThis study was approved by our institutional review board in accordance with standards of the National Institutes of Health. Five consecutive adult patients who received a diagnosis of AT/RT from January 2001 to October 2009 were included in the study. All patients had undergone surgical resection of their tumor and had received postoperative radiation therapy and chemotherapy. The resection specimens were collected and analyzed at 1 central pathology laboratory. Definitive diagnosis was based on histologic and immunohistochemical evaluation...
Diet-derived advanced glycation end products (AGEs) contribute significantly to accumulation of AGEs in renal insufficiency. To test whether modulation of dietary AGEs would impact on progression of chronic renal disease, 5/6 nephrectomy rats were randomly placed on three diets that differed only in AGEs content (low AGEs diet (LAD), high AGEs diet (HAD), and standard rodent diet (SRD)) for 5-13 weeks. Compared with SRD- or HAD-fed rats, LAD-treated animals showed decreased proteinuria and retarded decline of creatinine clearance without alteration of blood pressure. Glomerular volume was reduced by 23% compared with HAD-fed rats at week 13 (P<0.001). Renal fibrosis progressed with time in the remnant kidneys from HAD-fed rats. However, LAD-fed animals presented a better-preserved structure of the kidneys. LAD-fed rats demonstrated significantly decreased serum and renal AGEs concentration (P<0.01 and P<0.01). This was associated with marked decrease of intrarenal advanced oxidation protein products and thiobarbituric acid reactive substances, as well as increase of glutathione peroxidase activity. LAD treatment also downregulated expression of monocyte chemoattractant protein-1 and transforming growth factor-1 and ameliorated macrophage infiltration in the remnant kidney. These results demonstrated that restriction of dietary AGEs intake retards progression of renal fibrosis and dysfunction in the remnant kidney model.
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