Aus den Archiven der Radiologischen Pathologie^{[1] [2]}

Zusammenfassung

Das System der Hirnventrikel ist Ursprungsort verschiedener Neoplasmen. Diese werden in vielen Fällen als Zufallsbefunde bei Querschnittsuntersuchungen mittels bildgebender Verfahren entdeckt, können sich aber auch, je nach ihrer Lokalisation, durch Beschwerden, wie z. B. Hirndrucksymptome, bemerkbar machen. Die Läsionen können von verschiedenen ventrikulären Strukturen ausgehen: dem Ependym, das die Ventrikel auskleidet (Ependymome), der subependymalen Schicht (Subependymome) oder dem Adergeflecht (Plexustumoren); es gibt aber auch Tumoren (z. B. die chordoiden Gliome), deren Ursprungszellen noch unbekannt sind. Weitere das Ventrikelsystem betreffende Neoplasmen sind zentrale Neurozytome, subependymale Riesenzelltumoren, Meningeome, rosettenbildende glioneuronale Tumoren sowie Metastasen. Differenzialdiagnostisch kommt bei einem intraventrikulären Neoplasma ein breites Spektrum verschiedener Tumoren in Betracht, und viele davon weisen im Bildgebungsbefund Ähnlichkeiten hinsichtlich Signalintensität und Kontrastverstärkung auf. Jedoch erleichtert die Kenntnis der Tumorlokalisation im Ventrikelsystem – zusammen mit Alter, Geschlecht und Grunderkrankungen der betroffenen Patienten – die differenzialdiagnostische Abklärung.

Abstract

A variety of neoplasms may arise in the ventricular system. Intraventricular neoplasms may be discovered as an incidental finding at cross-sectional imaging or may manifest with varied symptoms depending on their location, including symptoms of increased intracranial pressure. These lesions may arise from various ventricular structures, including the ependymal lining (eg, ependymoma), subependymal layer (eg, subependymoma), or choroid plexus (eg, choroid plexus neoplasms), or they may have a cell of origin that has yet to be determined (eg, chordoid glioma). Other neoplasms involving the ventricular system include central neurocytoma, subependymal giant cell tumor, meningioma, rosette-forming glioneuronal tumor, and metastases. The differential diagnosis for intraventricular neoplasms can be broad, and many of them have similar patterns of signal intensity and contrast enhancement at imaging. However, the location of the lesion in the ventricular system – along with knowledge of the patient’s age, gender, and underlying conditions – will help narrow the differential diagnosis.

¹ © 2013 The Radiological Society of North America. All rights reserved. Originally puplished in English in RadioGraphics 2013; 33: 21 – 43. Online published in 10.1148/rg.331125192. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inaccuracy or error arising from the translation from English to German.

² Mit Unterstützung des American Institute for Radiologic Pathology (AIRP), des Joint Pathology Center (JPC) und der Uniformed Services University of the Health Sciences (USU)

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