A variety of neoplastic and nonneoplastic conditions involve the corpus callosum, which may result in a “butterfly” appearance on conventional MRI. Typically, that pattern shows a bilateral and heterogeneous contrast enhancement of the lesion, occasionally with central nonenhancing areas indicating intralesional necrosis. In contrast, anaplastic gliomas may show only minimal or even a lack of contrast enhancement on MRI. We here report neuroimaging findings in a 69-year-old man with a “butterfly” pattern on dynamic FET [O-(2-[18F]-fluoroethyl)-L-tyrosine] PET and the diagnosis of an anaplastic astrocytoma (WHO grade III; IDH-1/−2 wildtype, no 1p/19q co-deletion) but without typical MRI contrast enhancement.
From the *Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
†Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
‡Center of Integrated Oncology, Universities of Aachen, Bonn, Cologne, and Duesseldorf
§Department of Neuropathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne
∥Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany.
Received for publication February 18, 2019; revision accepted June 5, 2019.
Conflicts of interest and sources of funding: none declared.
Correspondence to: Norbert Galldiks, MD, Institute of Neuroscience and Medicine, Research Center Juelich, Leo-Brandt-St. 5, 52425 Jülich, Germany and Department of Neurology, University Hospital Cologne, Josef-Stelzmann St. 9, 50937 Cologne, Germany. E-mails: firstname.lastname@example.org; email@example.com.
Online date: July 25, 2019