PMC6388961_01
Brain MRI scans.. Notes: MRI before treatment (A-D): (A) axial T2W shows a hyperintense signal alteration in the right side of the pons; (B) axial T1W post-contrast; (C) sagittal T1W post- contrast; and (B and C) increased enhancement within the tumor. (D) 3D-ASL CBF shows increased CBF value in the right pons. MRI after treatment (E-H): (E) axial T2W shows a decreased hyperintense signal in the right side of the pons compared to pretreatment; (F) axial T1W post-contrast; (G) sagittal T1W post-contrast; and (F and G) disappeared right pontine lesion. (H) 3D-ASL CBF shows decreased CBF value in the right pons compared to pretreatment.. Abbreviations: 3D-ASL, three-dimensional arterial spin labelling; CBF, cerebral blood flow; T1W, T1 weighted; T2W, T2 weighted.
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T1-weighted (T1W) MRI showed increased enhancement within the tumor. Three-dimensional arterial spin labeling (3D-ASL) showed increased cerebral blood flow (CBF) value in the right pons (Figure 1). T1W post-contrast MRI showed that the right pontine lesion had disappeared. 3D-ASL showed decreased CBF value in the right pons compared to pretreatment (Figure 1E-H).
Histopathologic and immunohistochemical examinations of the biopsy tissue.. Notes: (A) H&E stain showed features of anaplastic astrocytoma (WHO grade III) with increased cellularity, nuclear atypia, and mitotic activity. (B) MiB1 (Ki-67) immunohistochemistry showed high proliferative activity with 60% positive cells. (C) GFAP immunohistochemistry. (D) Oligo-2 immunohistochemistry. (E) VEGFR-1 immunohistochemistry. (F) VEGFR-2 immunohistochemistry. (G) CD117 (c-kit). (H) H3K27M immunohistochemistry. Staining was positive for GFAP, oligo-2, VEGFR1, and VEGFR2 and negative for c-kit and H3K27M. Magnification 400x.. Abbreviation: VEGFR, vascular endothelial growth factor receptor.
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Vascular endothelial growth factor receptor-1 (VEGFR-1) and vascular endothelial growth factor receptor-2 (VEGFR-2) were positive; the tumor was negative for stem cell factor receptor (c-kit, CD117) and H3K27M (Figure 2).