Pineal parenchymal tumor (WHO grade III)

An enhancing mass is noted with its epicenter in the region of the pineal gland. The ventricular system is enlarged, due to compression of the cerebral aqueduct. Hemorrhage is common with pineal parenchymal tumors, and is visualized in the current case (specifically hemosiderin, with low signal intensity) on the T2 FSE and DWI scans, but is best seen on SWI. On CT, these tumors are frequently hyperdense, as with this example. A pineal parenchymal tumor of intermediate differentiation (PPTID) – the specific diagnosis in this case – is an official WHO category, and is a neoplasm that is considered to be intermediate in biologic behavior between pineoblastoma and pineocytoma. Grade 1 pineal parenchymal tumors are pineocytomas, grade 2 and 3 PPTIDs, and grade 4 pineoblastomas.

Pineal parenchymal tumor (WHO grade III)

Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015)