Aus den Archiven des AFIP (Armed Forces Institute of Pathology): Läsionen der Pinealisregion: radiologisch-pathologische Korrelation

Zusammenfassung

Zu den Läsionen der Pinealisregion gehört eine Reihe unterschiedlicher Entitäten. Die häufigsten Neoplasien sind Keimzelltumoren. Diese können hormonell aktiv sein, sodass eine Untersuchung der Onkoproteinkonzentration im Serum oder Liquor die Diagnosefindung unterstützen kann. Zu den Neoplasien, die aus dem Pinealisparenchym entstehen, zählen das niedriggradige Pinealozytom, der Pinealisparenchymtumor intermediärer Differenzierung und das hoch maligne Pinealoblastom. Für Keimzelltumoren und Neoplasien des Pinealisparenchyms gibt es keine pathognomonischen Zeichen der Bildgebung, aber die Bildgebung in Kombination mit Laboruntersuchungen kann die Differenzialdiagnose eingrenzen. Neoplasien können auch aus einer Reihe anderer Zelltypen entstehen, die sich in der Nähe der Zirbeldrüse befinden. Hierzu gehören Lipome, Meningeome und Astrozytome. Auch kongenitale Läsionen, wie Epidermoidzysten, Dermoidzysten und Lipome, können vorkommen. Die Kenntnis der verschiedenen Läsionen, die in der Pinealisregion auftreten können, ihre Ansicht in der Bildgebung und ihre klinischen Merkmale helfen bei der Eingrenzung der radiologischen Differenzialdiagnose und der Optimierung der Patientenversorgung.

Abstract

Lesions of the pineal region include a diverse group of entities. The most common neoplastic lesions are the germ cell tumors. Germ cell tumors may be hormonally active, and evaluation of serum or cerebrospinal fluid levels of oncoproteins assists in making the diagnosis. Neoplasms arising from the pineal parenchyma include the low-grade pineocytoma, pineal parenchymal tumor of intermediate differentiation, and the highly malignant pineoblastoma. Germ cell tumors and pineal parenchymal neoplasms do not have pathognomonic imaging findings, but imaging in combination with laboratory evaluation helps narrow the differential diagnosis. Neoplasms may also arise from the variety of cell types residing in the proximity of the pineal gland. These include lipomas, meningiomas, and astrocytomas. Congenital lesions such as epidermoid and dermoid cysts and lipomas can also occur. Knowledge of the variety of lesions that occur in the pineal region, their imaging appearances, and their clinical features assists in narrowing the radiologic differential diagnosis and optimizing patient treatment.

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1 © 2011 The Radiological Society of North America. All rights reserved. Originally published in English in RadioGraphics 2010; 30 : 2001 – 2020. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inacuracy or error arising from the translation from English to German.