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Diffuse leptomeningeal glioneuronal tumor (DLGNT) mimicking Whipple’s illness: a case report and literature evaluate.

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Diffuse leptomeningeal glioneuronal tumor (DLGNT) mimicking Whipple’s illness: a case report and literature evaluate.

Childs Nerv Syst. 2017 Aug;33(eight):1411-1414

Authors: Karlowee V, Kolakshyapati M, Amatya VJ, Takayasu T, Nosaka R, Sugiyama Okay, Kurisu Okay, Yamasaki F

Summary
INTRODUCTION: Diffuse leptomeningeal glioneuronal tumor is a brand new entity underneath the neuronal and combined neuronal-glial tumors within the WHO 2016 up to date classification and generally present in kids and adolescents. The preliminary analysis is difficult due to its non-specific radiologic function and damaging CSF cytology evaluation. A 17 years male was introduced with intractable headache subsequently adopted by again ache and joint ache. MRI confirmed enhancement of arachnoid membrane at basal cistern, bilateral sylvian fissure and cerebral cistern with slight enlargement of ventricles. There have been no evidences of an infection in CSF and blood samples. Based mostly on the duodenal biopsy and prodromal symptom of joint ache, the affected person was suspected of getting Whipple’s illness. Eleven months after the onset, a small mass lesion was noticed on the anterior horn of proper lateral ventricle. The histology was outstanding for anaplastic oligodendroglioma. Immunostainings revealed positivity for GFAP, Olig2, synaptophysin and negativity for IDH1 mutation, H3K27M. MIB1 labeling index was 40% and 1p19q FISH evaluation confirmed solely 1p deletion. Subsequently, a last analysis of DLGNT was made.
CONCLUSION: DLGNT must be included as a differential analysis of sufferers with leptomeningeal-enhanced and excessive CSF protein stage with regular white blood cell depend.

PMID: 28382437 [PubMed – indexed for MEDLINE]

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