central neurocytoma radiology

National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. From the Radiologic Pathology Archives: Intraventricular Neoplasms: Radiologic-Pathologic Correlation. Central neurocytoma (CN) was first described in 1982 by Hassoun et al 1 as a rare intraventricular tumor that is typically located in deep midline structures and arises usually in young adults. 2008;29 (1): 190-1. There is no reported gender predilection 10. in 1982, and became a well-defined clinical and pathological entity , by the early 1990s. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK "WHO Classification of Tumours of the Central Nervous System. The first report resulted in increased recognition of the tumor, and a number of reports have since been published in the literature. Zhang D, Wen L, Henning TD, Feng XY, Zhang YL, Zou LG, Zhang ZG. ... [8-10]. imaging. A case of central neurocytoma treated surgically is described. ... CT scan and magnetic resonance imaging (MRI) revealed temporal bone tumor extending right orbital bone and diffuse leptomeningeal thickening. These lesions may obstruct spinal fluid flow and/or put pressure on surrounding structures, causing symptoms including headaches and confusion. Neuronal and Mixed Neuronal-Glial Tumors. MRS was also obtained for one additional case. Central neurocytoma, abbreviated CNC, is a rare neuropathology tumour. Cystic regions are frequently present, especially in larger tumors. Contrast enhancement is usually mild to moderate. Also rare, is a sudden presentation due to intraventricular hemorrhage 7. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Central Neurocytoma. Dr Balaji Anvekar FRCR Neuro and MSK Consultant Radiologist. A surgical biopsy of the lesion was taken. [1] who studied two patients with intraven - tricular tumors using electron microscopy. Extraventricular neurocytomas are histologically similar but lack an intraventricular component 11. Central neurocytoma (CN) is an uncommon brain tumor arising primarily in the lateral ventricular near the foramen of Monro and approximately accounting for 0.1-0.5% of all primary tumors of the central nervous system. Calcification is seen in over half of cases, usually punctate in nature 4,10. Subependymoma of the cerebellopontine angle and prepontine cistern in a 15-year-old adolescent boy. ATYPICAL CENTRAL NEUROCYTOMA: REPORT OF TWO CASES. “Central Neurocytoma of the Fourth Ventricle.” ... natural history, imaging features and gross surgical and pathologic features of Pleomorphic Xanthoastrocytoma. Please enable it to take advantage of the complete set of features! Central Neurocytoma-CT Imaging 12 years ago 3D CT, Brain tumour, Neurocytoma, Teleradiology Imaging of central neurocytoma is usually characteristic. Methods Preoperative MR images of 30 CNs and another 68 intraventricular non-CN tumours were analysed by one experienced neuroradiologist retrospectively to identify previously reported features and new features of CN. Tortori-Donati P, Fondelli MP, Rossi A et-al. Update on the diagnosis, pathogenesis, and treatment strategies for central neurocytoma. In this case, we notice a dilatation of both lateral ventricles, but with no transependymal CSF permeation, which indicates chronic hydrocephalus and slow-growing mass. Rarely central neurocytomas may be associated with sudden death secondary to acute ventricular obstruction 4. It accounts approximately 0.25–0.5% of intracranial tumors. Central neurocytoma is a hypervascular tumor but spontaneous intratumoral bleeding is very uncommon [5]. Tetraventricular central neurocytoma: A rare presentation with imaging-pathologic correlation. 1991;156 (6): 1311-3. Diagnostic value of six MRI features for central neurocytoma. Central neurocytoma (CN) was originally described by Hassoun et al. Objectives: We report a case of neurocytoma located in the fourth ventricle and extended into the third ventricle. Case Discussion. Objectives: To evaluate clinical findings and radiological characteristics of central neurocytoma (CN) in 18 patients and magnetic resonance spectroscopy (MRS) features in one additional case. Mild obstructive hydrocephalus is present. 7. Coronal drawing depicts a central neurocytoma within the body of the left lateral ventricle. Histologic and immunopathologic examination showed low-grade characteristics with neuronal differentiation (synaptophysin and neuronal nuclear antigen were positive), these findings indicating central neurocytoma. In this report, we describe a very rare case of tetraventricular CN with imaging-pathologic correlation, and discuss their atypical features in a location together with treatment options. Materials and methods: Clinical and imaging findings of 18 patients (nine female and nine male; age range, 18-37 years old (27.8±5.7)) with histopathological diagnosis of CN were evaluated retrospectively. An intra ventricular neuro epithelial tumour. AJNR Am J Neuroradiol. 2013 Apr;68(4):e206-12. Coronal drawing depicts a central neurocytoma within the body of the left lateral ventricle. A tumor blush is frequently identified, with the mass supplied by choroidal vessels. However, this was upgraded in 1993 to WHO grade II (and remains so in the 2016 version) as it was recognized that at least some of these tumors exhibited more aggressive behavior 10. Interventricular neurocytoma: radiologic features and review of the literature. Author information: (1)Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China. Bookmarks (0) Brain. Calcifications are common. The initial description classified them as WHO grade I lesions. HHS 27 (3): 434-40. T1 C+ 2.1. mild-moderate heterogeneous enhancement 3. Central neurocytomas are usually hyperattenuating compared to white matter. Central neurocytomas are usually hyperattenuating compared to white matter. When only incomplete resection possible or extraventricular extension is present, then adjuvant radiotherapy (and sometimes chemotherapy) are added, although their benefit is not well established. Typical locations include 4: Central neurocytomas are usually friable grey-colored tumors, sometimes demonstrating areas of calcification and hemorrhage 11. Central neurocytomas are generally noncancerous (benign) brain tumors in the ventricles, which are the fluid-filled spaces within the brain. Central neurocytomas are rare tumors, typically found in the third ventricle. zhangbo0616@sohu.com Central neurocytoma (CNC) is an uncommon benign tumor of the central nervous system (CNS) occurring in adults and is more likely to be located in the region of the foramina of Monra. Central neurocytoma: proton MR spectroscopy and diffusion weighted MR imaging findings. Case report. Most of the patients present with symptoms of increased intracranial pressure secondary to the obstructive hydrocephalus [1, 2, 4]. Radiology Cases and Radiology Case Reports. (2009) Magnetic resonance imaging. Neuronal and Mixed Neuronal-Glial Tumors. Two radiologists read the images retrospectively. T2/FLAIR 3.1. typically iso to somewhat hyperintense compared to brai… 2016 Jul;146:18-23. doi: 10.1016/j.clineuro.2016.04.012. Copyright © 2012 Elsevier Masson SAS. The authors review the literature. This image also shows an entrapped right frontal horn indicated by incomplete suppression of cerebrospinal fluid. 4. Central neurocytoma (CN) was first described in the 1980’s by Hassoun et al. Ganglioneurocytoma is a variant, usually of extraventricular neurocytomas, demonstrating a distinct ganglion cells component 6,11,12. Central neurocytoma (CN) is a benign intraventricular neuronal tumor with a favorable prognosis. This site needs JavaScript to work properly. Medical illustration by James A. Cooper, MD, Radiology Medical Group, San Diego, California ([email protected], www.cooperspective.com). OBJECTIVES: To evaluate clinical findings and radiological characteristics of central neurocytoma (CN) in 18 patients and magnetic resonance spectroscopy (MRS) features in … Radiographics. Emphasis is placed on radiological and pathological features not previously described. Cases of CSF dissemination have been reported, but are rare 10. Calcification is seen in over half of cases, usually punctate in nature 4,10. Osborn AG, Salzman KL, Jhaveri MD. Central neurocytoma is a rare intracranial neoplasm arise most commonly in the lateral ventricles particularly in the frontal horns near the foramen of Monro with a characteristic attachment to the septum pellucidum. 9. COVID-19 is an emerging, rapidly evolving situation. The majority of CNC are located entirely within the ventricles, close to the foramen of Monro [3-4]. Figure 1: histology - "salt and pepper" appearance, Intraventricular meningioma - third ventricle, typically iso to somewhat hyperintense compared to brain, numerous cystic areas (bubbly appearance), many of which completely attenuate on FLAIR, calcification is common, typically punctate, hemorrhage (especially in larger tumors) is common, uncommonly results in ventricular hemorrhage, diffusion restriction of the solid component, glycine peak (3.55ppm) has also been reported, supratentorial tumors (esp in children) often have a significant extraventricular (parenchymal) component, may have ependymoma components and look very similar, typically show intense contrast enhancement, this is especially difficult in cases where there is a parenchymal component as histologically the tumors are very similar. Bookmarks (0) Brain. Seventy-two percent of patients with central neurocytoma are diagnosed at the age of 20–40 years old; 12 the tumour is exceptional in the first decade and after 50 years. Intraventricular tumor with imaging features favoring a central neurocytoma (somewhat atypical in a patient of this age) or subependymoma. The interesting point about intratumoral hemorrhage of central neurocytoma is that it may not appear on CT images, and may only be discernible on MR imaging [8]. Most of them occur as an exophytic, well circumscribed, globular mass that protrudes into the ventricles. Complete surgical resection is usually curative (5 years survival 81%). Radiographics. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Central Neurocytoma. We, therefore, investigated the similarities and differences between these types of tumors to get a better understanding of how they … Aim: To evaluate the clinical, pathological and neuroradiological features of intraventricular central neurocytoma in six patients. Eight patients underwent CT and eight had MR imaging. Extraventricular neurocytoma with ganglionic differentiation associated with complex partial seizures. 2. A relatively short clinical course, typically only a few months, is most common. Central neurocytoma. No large feeding arteries are usually seen. Clinical data, such as presenting symptoms and medical histories were collected. Both MR and CT images were acquired for other two patients. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Would you like email updates of new search results? Central neurocytoma (CN) was originally described by Hassoun et al. Emphasis is placed on radiological and pathological features not previously described. Central neurocytoma (CN) is a well-demarcated intraventricular neurocytic neoplasm affecting usually adolescents without sex predominance. A This is a postoperative post shunting case of neurocytomas, note the intraventricular nature of tumour, calcification and operative pneumocephalus. Ma Z, Yan H, Shi H, Li Y, Song J, Huang J, Hong X. Clin Neurol Neurosurg. 5. It usually occurs in young adults with no sex predilection and constitutes approximately 0.1-0.5 % of all intracranial tumours [1-2]. Pathology-based Diagnoses. Tonn J, Westphal M, Rutka JT. Author information: (1)Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China. Neoplasms. Accompanying ventricular dilatation often present. Although structural imaging findings of CNC are typical, they are not specific.  |  Materials and methods: Six patients were imaged using non-enhanced and contrast-enhanced magnetic resonance imaging (MRI); three of them were also examined using non-enhanced computed tomography (CT). Classic MRI and CT findings of central neurocytoma, which was histologically proven. Figure 1: (Top Left) This large central neurocytoma demonstrates its typically cystic feature on axial FLAIR. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Immunohistochemistry confirms the purely neuronal origin by positivity to neuronal markers such as 11: Importantly, IDH mutations and 1p19q co-deletion are absent (characteristic of oligodendrogliomas). We report a case of neurocytoma located in … Clipboard, Search History, and several other advanced features are temporarily unavailable. Contrast enhancement is usually mild to moderate. Central neurocytoma presenting with intraventricular hemorrhage: case report and review of literature. NLM The role of … Diagnosis. Computed tomography and magnetic resonance features of extraventricular neurocytoma: a study of eight cases. 2018 Oct;28(10):4306-4313. doi: 10.1007/s00330-018-5442-y. Syn : Neurocytoma. Aim: To evaluate the clinical, pathological and neuroradiological features of intraventricular central neurocytoma in six patients. The tumor is typically supratentorial, located in the lateral ventricles adjacent to the foramen of Monro. Materials and methods: Kocaoglu M, Ors F, Bulakbasi N, Onguru O, Ulutin C, Secer HI. Clinical symptoms at the time of presentation were headaches (n=11), dizziness (n=6), visual disturbances (n=2), etc. [1] who studied two patients with intraven - tricular tumors using electron microscopy. The maximum diameter of the CNs varied from 3.4 to 9.2 cm (5.2±1.5 cm). (2009) ISBN:364202873X. 2005;105 (4): 218-25. Central Neurocytoma Parker DR. Neuroradiology case of the day. OBJECTIVES: To evaluate clinical findings and radiological characteristics of central neurocytoma (CN) in 18 patients and magnetic resonance spectroscopy (MRS) features in … The vast majority of central neurocytomas are located entirely within the ventricles. Two radiologists read the images retrospectively. Three tumours continued towards the foramen of Monro and one to the third ventricle. RTU-26. Central neurocytomas are rare tumors, typically found in the third ventricle. Check for errors and try again. Magn Reson Imaging 2009;27:434–440. On CT, diffuse and diverse calcifications were observed in nine cases and cysts varying in sizes were revealed in all. Central neurocytomas have a well-delineated, smooth or lobulated margin and are moderately vascular. T1 1.1. isointense to grey matter 1.2. heterogeneous 2. They are typically seen in young patients and generally have a good prognosis provided a complete resection can be achieved. Radiology. Koral K, Kedzierski RM, Gimi B et-al. CN is almost exclusively located in the body of lateral ventricle in young adults. They also demonstrate areas of variable architecture that are reminiscent of other tumors, including oligodendrogliomas, pineocytomas and neuroendocrine tumors 11. Philadelphia, PA: Elsevier, 2016. A First described in 1982 by Hassoun et al, central neurocytoma (CN) is a rare tumor of neuroglial origin. 10. Koeller KK, Sandberg GD. Materials and methods: Clinical and imaging findings of 18 patients (nine female and nine male; age range, 18-37 years old (27.8±5.7)) with histopathological diagnosis of CN were evaluated retrospectively. in 1982, and became a well-defined clinical and pathological entity , by the early 1990s. Central neurocytoma: clinical, pathological and neuroradiological findings. Shin JH, Lee HK, Khang SK et-al. Unable to process the form. Imaging of central neurocytoma is usually characteristic. NIH Diagnostic Imaging (3rd ed). Heterogeneous moderate enhancement (5/8) was present on T1 postcontrast images. link. Surgery is the standard treatment for central neurocytomas. The typical and atypical MR imaging findings of central neurocytomas: Report on eighteen cases and review of the literature. Pathology-based Diagnoses. 18 (6): 1175-8. Central Neurocytoma 2015 Oct-Dec;6(4):594-7. doi: 10.4103/0976-3147.165415. Central neurocytoma with clinically malignant behavior. Eight lesions were unilateral ventricle (44%) and ten were located in both lateral ventricles. A 36-year old Malay lady presented with an 8-month history of frontal headache which was throbbing in nature. Epub 2018 Apr 30. 2006 Apr;61(4):348-57. doi: 10.1016/j.crad.2006.01.002. Li X, Guo L, Sheng S, Xu Y, Ma L, Xiao X, Si Z, Chen Y, Wu Y. Eur Radiol. Isaac Yang. 11. AJR Am J Roentgenol. Overview First described in 1982 by Hassoun et al, central neurocytoma (CN) is a rare tumor of neuroglial origin. [1, 2] CN is generally regarded as a benign neoplasm with a favorable prognosis and affects mainly young adults.The mean age of presentation is 29 … Central neurocytoma is a recently described, rare primary brain tumor of neuronal origin, which is characterized by predominant occurrence in the young adults, exclusive later- al ventricular location, and oligodendroglioma-like histolo- gy (1,8, 12-14, 17). ... Central Neurocytoma. Diagnosis. Extraventricular neurocytomas (previously known as cerebral neurocytomas) are distinctly uncommon and discussed in a separate article. 13. 22 (5): 1177-89. Author information: (1)Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China. Central neurocytoma is a rare brain tumour composed of uniform round cells with neuronal differentiation. Neuronal tumors of the central nervous system: radiologic findings and pathologic correlation. CN is a benign tu-mor of the central nervous system that is classified as a grade II tumor by the World Health Organization (WHO) [2,3]. The distinct radiological features such as: (1) diffuse and diverse calcifications on CT images; (2) clusters of cysts of varying sizes resulting in the "swiss cheese/soap bubble" appearance on T2WI and heterogeneous moderate enhancement on MR images; (3) the incorporation of the septum pellucidum in bilateral tumours and abutting of the septum pellucidum in unilateral tumours together with the attachment of the wall of the ventricles can help in the diagnosis of preoperative central neurocytoma. CN is a benign tu-mor of the central nervous system that is classified as a grade II tumor by the World Health Organization (WHO) [2,3]. Smith A, Smirniotopoulos J, Horkanyne-Szakaly I. Without ultrastructural and immunohis-  |  The tumor location is an important imaging finding as the tumor is typically midline and broad based attachment to the septum pellucidum. Other differentials for an intraventricular mass including an ependymoma or intraventricular metastasis are felt less likely given the imaging appearances. 8. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 6. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":1076,"mcqUrl":"https://radiopaedia.org/articles/central-neurocytoma/questions/778?lang=us"}. The authors review the literature. The mass is attached to the septum pellucidum but does not extend outside the ventricle. Cerebral intraventricular neoplasms: radiologic-pathologic correlation. Central neurocytoma: proton MR spectroscopy and diffusion weighted MR imaging findings. Central Neurocytomas, An Issue of Neurosurgery Clinics of North America,. (Courtesy of Amirsys, Salt Lake City, Utah.) It is discovered due to symptoms of raised intracranial pressure. Results: The first report resulted in increased recognition of the tumor, and a number of reports have since been published in the literature. Central Neurocytoma Non contrast CT study of brain of a 40 yo male. We present the unusual case of a fourth ventricular central neurocytoma in a 70-year-old female presenting with imbalance and headaches, with an enhancing fourth ventricular mass on imaging. Keywords: Central neurocytoma, treatment, radiology. AJNR Am J Neuroradiol. Typically, central neurocytomas present with symptoms of increased intracranial pressure, headaches being most frequent, or seizures (especially tumors with extraventricular extension). CASE REPORT: PLEOMORPHIC XANTHOASTROCYTOMA (PXA) IN A 9YO WITH TP53 MUTATION. The cells are typically uniform and round with a salt and pepper finely speckled chromatin 11. Smets K, Salgado R, Simons PJ et-al. AJNR Am J Neuroradiol. Goergen SK, Gonzales MF, McLean CA. Central neurocytomas demonstrate neuronal differentiation and histologically appear similar to oligodendrogliomas which, historically, resulted in many tumors erroneously categorized. Most of them occur as an exophytic, well circumscribed, globular mass that protrudes into the ventricles. Neoplasms. A number of cases have been reported after this tumor was first described by Hassoun et al in 1982. Oncology of CNS Tumors. 4th Edition Revised". In particular, the intra-operative ultrasound appearance is described. Central neurocytomas are WHO grade II neuroepithelial intraventricular tumors with fairly characteristic imaging features, appearing as heterogeneous masses of variable size and enhancement within the lateral ventricle, typically attached to the septum pellucidum. 1. Most CNs are benign, well-differentiated tumors that exhibit neuronal differentiation and have an indolent clinical course after their initial presentation as obstructive hydrocephalus or visual disturbance. Familial multiple cavernous malformation, caused by mutation in Krev interaction trapped protein 1 gene (KRIT-1) Objectives: To evaluate clinical findings and radiological characteristics of central neurocytoma (CN) in 18 patients and magnetic resonance spectroscopy (MRS) features in one additional case. Accompanying ventricular dilatation often present. Tomura N, Hirano H, Watanabe O et-al. All rights reserved. Extra ventricular Neurocytoma is known but rare. On DWI, the tumours had heterogeneous hyperintense appearances and the tumour NADC values were 0.93±0.21.On MRS, elevated Cho and Gly peaks and reduced Cr and NAA peaks were obtained. Kocaoglu M, et al. Materials and methods: Six patients were imaged using non-enhanced and contrast-enhanced magnetic resonance imaging (MRI); three of them were also examined using non-enhanced computed tomography (CT). Nishio S, Morioka T, Suzuki S, Mihara F, Fukui M. Neurosurg Clin N Am. It usually occurs in young adults with no sex predilection and constitutes approximately 0.1-0.5 % of all intracranial tumours [1-2]. Clinical and imaging findings of 18 patients (nine female and nine male; age range, 18-37 years old (27.8±5.7)) with histopathological diagnosis of CN were evaluated retrospectively. 1. From the archives of the AFIP. A case of central neurocytoma treated surgically is described. Central neurocytoma (CN) is an uncommon brain tumor arising primarily in the lateral ventricular near the foramen of Monro and approximately accounting for 0.1-0.5% of all primary tumors of the central nervous system. doi: 10.1016/j.crad.2012.11.009. Central neurocytomas are typically seen in young patients (70% diagnosed between 20 and 40 years of age) and account for less than 1% (0.25-0.5%) of intracranial tumors 10,11. Acta Neurol Belg. Central neurocytoma (CN) was first described in the 1980’s by Hassoun et al. 22 (6): 1473-505. 2013;33 (1): 21-43. Patel DM, et al. 3. link. Epub 2013 Jan 17.  |  Central neurocytoma is a rare brain tumour composed of uniform round cells with neuronal differentiation. The prognosis of central neurocytoma is favorable in most of the cases; however malignant course of this tumor has been established very uncommonly [9, 10]. [Neuroimaging features of intraventricular neurocytoma]. Sunday, 1 January 2012. Radiographics. 1992;182 (3): 787-92. We also assessed the tumour NADC values. Clusters of cysts gave the tumours a "swiss cheese/soap bubble" inhomogeneous hyperintense appearance on T2WI and FLAIR images. To evaluate clinical findings and radiological characteristics of central neurocytoma (CN) in 18 patients and magnetic resonance spectroscopy (MRS) features in one additional case. The radiological appearances of central neurocytoma are discussed. 2015 Jan;26(1):11-9. doi: 10.1016/j.nec.2014.09.012. A case of central neurocytoma occurring in the thalamus, confirmed by electron microscopy and immunohistochemistry, is reported. We present the unusual case of a fourth ventricular central neurocytoma in a 70-year-old female presenting with imbalance and headaches, with an enhancing fourth ventricular mass on imaging. Cystic regions are frequently present, especially in larger tumors. Clin Radiol. Clin Radiol. Computed tomography demonstrated a hypodense mass with an irregular margin arising from the right thalamus, extending into … Conclusion: Akakin A, Yilmaz B, Demir MK, Yapicier O, Toktas ZO, Kilic T. J Neurosci Rural Pract. Springer Verlag. Studies comparing intraventricular oligodendroglioma (IVO) and central neurocytoma (CN) in terms of their clinical, radiological and pathological features are scarce. 12. On MRI, the solid parts of the tumours were mainly hypo- to isointense on all T1WI and isointense to grey matter on T2WI. -. 1999;20 (4): 724-7. Epub 2016 Apr 23. To increase our understanding of the imaging features of central neurocytoma (CN) and improve the preoperative MRI diagnosis accuracy. USA.gov. Less likely given the imaging features of intraventricular central neurocytoma ( CN ) was originally described by Hassoun al! Immunohistochemistry, is reported were located in the 1980 ’ s by Hassoun et al heterogeneous moderate enhancement 5/8! Survival 81 % ) and improve the preoperative MRI diagnosis accuracy but lack an intraventricular component.. ( Courtesy of Amirsys, salt Lake City, Utah. matter T2WI. Punctate in nature intraventricular Neoplasms: Radiologic-Pathologic correlation, People 's Republic of China Secer! Recognition of the cerebellopontine angle and prepontine cistern in a 9YO with TP53 MUTATION,,. Was throbbing in nature 4,10 were acquired for other two patients with -... Search history, and several other advanced features are temporarily unavailable clinical course, typically found in the third.. Tumor extending right orbital bone and diffuse leptomeningeal thickening histologically appear similar to oligodendrogliomas which, historically, resulted increased! And are moderately vascular ; 6 ( 4 ): e206-12 orbital bone and diffuse leptomeningeal thickening in.. Which, historically, resulted in increased recognition of the central nervous system: features. 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