Tinkle Christopher L, Orr Brent A, Lucas John T, Klimo Paul, Patay Zoltan, Baker Suzanne J, Broniscer Alberto, Qaddoumi Ibrahim
Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2017 Aug;64(8). doi: 10.1002/pbc.26416. Epub 2017 Jan 13.
A 4-year-old male presented with rapid-onset cranial nerve palsy and ataxia. Brain magnetic resonance imaging (MRI) revealed a pontine mass lesion with discordant conventional and advanced imaging. A stereotactic core biopsy revealed glioblastoma with immunostaining suggestive of histone H3K27M and TP53 mutation, consistent with diffuse intrinsic pontine glioma. MRI 3 months after radiotherapy revealed extensive new leptomeningeal metastatic disease involving both the supra- and infratentorial brain, as well as the imaged portion of the spine. Tissue procured at the time of needle biopsy has undergone striking in vivo expansion as an orthotopic xenograft.
一名4岁男性出现快速进展的颅神经麻痹和共济失调。脑部磁共振成像（MRI）显示脑桥有一个肿块病变，其传统成像和高级成像表现不一致。立体定向核心活检显示为胶质母细胞瘤，免疫染色提示组蛋白H3K27M和TP53突变，符合弥漫性脑桥内在型胶质瘤。放疗后3个月的MRI显示广泛的新的软脑膜转移疾病，累及幕上和幕下脑以及脊柱的成像部分。针吸活检时获取的组织作为原位异种移植在体内有显著的生长。
