Neuro mass differentials from AFIP
Terms
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Location
Differential -
CPA cistern (extra-axial)
* Vestibular Schwannoma
* Meningioma
* Epidermoid (no enhancement, undulating margin)
* Glomus Tumor, Mets, Endolymphatic Sac Tumor
* Extension from 4th or Primary CPP and Ependymoma -
Location
Differential -
4th Vent / Vermian Mass
* PNET (medulloblast) - usu DENSE on NCT
* Ependymoma - usu MIXED w/Ca &small "cysts"
* Choroid Plexus Papilloma (adults) -
Location
Differential -
Hemispheric Cerebellar Mass/ Cyst+Nodule
* Pilocytic Astrocytoma (5-15 yrs)
* Hemangioblastoma (35-45 yrs)
* Other Hemispheric Masses:
-Mets, Infarction, Abscess -
Location
& differential -
Sella & Parasellar / Suprasellar
* Pituitary Adenoma (adults)
* Craniopharyngioma
* Hypothalamic Glioma (kids)
* Chordoma, Meningioma, Mets
* Histiocytosis, Germinoma, Lymphoma, Sarcoid
* Aneurysm -
Location &
differential -
3rd Ventricle
* Colloid Cyst
* CPP, Ependymoma
* Vertical Ext Suprasellar Mass
* Anterior Ext of Pineal Mass
* Cysticercosis -
Location
& differential -
Basal Ganglia
Bilat Symmetric (tox/metab)
* Putamen - Methanol
* Globus Pallidus - CO
* Genetic Disorders
Bilateral Asymmetric (hematog)
* Infection (Toxo, etc.)
* Metastasis
Unilat (acquired/neoplastic):
* Thalamic Glioma (astrocyt)
* Hypertensive Hematoma (Dx of exclusion) -
Differentials
for each location -
Lateral Ventricle
* F. Monro
o SEGA
o Subependymoma
* Body
o Subependymoma, etc.
* Trigone
o Child - CPP
o Adult - Meningioma -
Location
and differential -
Pineal Region (Quadrigeminal Cistern)
* Pineal Parenchyma
o Pineocytoma, Pineoblastoma
* Pineal Cyst (=CSF on T1&2; hi FLAIR)
* Germ Cell Tumor -
o "atypical teratoma"
* Extension of Glioma (Astrocytoma)
o corp call, tectum, thalamus
* Meningioma
* Lipoma
* Vein of Galen Malformation
* Epidermoid -
Location
& differential -
Corpus Callosum
Expanding or Enhancing
- Astrocytoma, Lymphoma
Destructive, Geographic
- WM Dz- MS, ADEM, PML
Patchy Periventricular
- Vascular: HT change, leukoariosis)
- Multifocal rings - Toxo in HIV
Uniform Periventricular
- Hydrocephalic edema -
Differential -
------GM Ribbon------
-Ischemia (+/-Infarct)
-HTN Encephalopathy, Eclampsia
-Cyclosporin
-Encephalitis (HSV), Meningitis
-Sturge-Weber Disease (Ca++)
-Meningioangiomatosis (Ca++)
-----Gray & White Wedge-----
-Infarct (vasc territory)
-Cortical Dysplasia
-Cortical Tuber (TS)
-DNET (LoT1 HiT2, no edema)
rare: Gangioglioma (cystic w/Ca++) -
Location
& Differential -
Epidural Space
* Hematoma
* Empyema
* Mets (Prostate, Breast, Lymphoma)
* Granulomatous dz(e.g. Sarcoid, TB, Fungal) -
Location
&
differential -
Subdural Space
* Hematoma
* Empyema
* Mets (Prostate, Breast, Lymphoma)
* Granulomatous Dz (Sarcoid, TB, Fungal)