CNS lesions (adult)

Question 1

Diffuse astrocytoma

Anaplastic astrocytoma

Answer 1

Both are expansile parenchymal lesions
Hypodense on CT
Hyperintense on T2
No significant enhancement

Question 2

Glioblastoma

Answer 2

Enhancing mass with surrounding vasogenic oedema
Central necrosis
+/- calcs and haemorrhage
Single or multifocal enhancing masses

Question 3

Oligodendroglioma

Answer 3

Expansile infiltrative mass
hypodense on CT
Hyperintense on T2
Frontal lobes
Extend peripherally to involve the cortex
Calcification common

Question 4

Hemangioblastoma

Answer 4

Cyst with a nodule
circumscribed enhancing tumour that secretes fluid - has internal or adjacent cysts
BENIGN - associated with VHL

Question 5

Subependymoma

Answer 5

Heterogenous, hypovascular
inferior 4th ventricle > lateral 3rd `. spine

Question 6

Choroid plexus tumour

Answer 6

intense enhancement
lobulated margins
centered on atrium or trigone of lateral ventricle

Question 7

Central neurocytoma

Answer 7

heterogenous “bubbly” appearance

Question 8

Primary CNS lymphoma

Answer 8

homogenous enhancing mass
abuts CSF spaced and wraps around ventricle
infiltrates CC

Question 9

Mets

Answer 9

one or multiple ring enhancing lesions