Diagnosis: Gliomatosis
Gliomatosis is also known as diffuse infiltrating glioma and gliomatosis cerebri. It is a unique form of astrocytoma in which the neoplastic cells diffusely infiltrate the white matter. Gray matter may also be involved. Patients with gliomatosis tend to present at a younger age when compared to the more typical high-grade astrocytomas. Findings of gliomatosis include isointense or hypointense T1 signal with increased T2 signal. There is usually little or no enhancement, and mass effect may be minimal. Leptomeningeal disease may also be seen. The differential here is limited due to this characteristic appearance. Lymphoma elsewhere which secondarily affects the brain may result in an infiltrative appearance vs. primary CNS lymphoma which typically produces a large enhancing mass. Related Cases Shin YM, Chang KH, Han MH, Myung NH, Chi JG, Cha SH, Han MC. Gliomatosis cerebri: comparison of MR and CT features. AJR, Oct 1993; 161(4):p859-62.