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Volume 64, Pages S82-S88 (November 2005)
An analysis of stereotactic biopsy of brain tumors and nonneoplastic lesions: a prospective clinicopathologic study Aylin Okcu Heper, MD, Esra Erden, MD, Ali Savas, MD, PhD, Koray Ceyhan, MD, Ilhan Erden, MD, Serdar Akyar, MD, Yücel Kanpolat, MD Surgical Neurology Volume 64, Pages S82-S88 (November 2005) DOI: /j.surneu Copyright © 2005 Elsevier Inc. Terms and Conditions
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Fig. 1 Stereotactic CT-MRI image fusion in a case with pineal region tumors. A: Three-dimensional display of the trajectory of the cannula. B: Preoperative stereotactic surgical planning on multiplanar MRI-fused image program. C: Probe view of the virtual biopsy trajectory in the tumor. D: The probe-view images provide critical surgical information: the trajectory is far away from the internal cerebral veins and other vascular structures. The biopsy tract should stay within the limits of −10 and 10 mm according to the targeted center of the tumor; cisternal and vascular structures at the pineal region may be damaged after +10 mm; no more tumor tissue at 15 mm. Surgical Neurology , S82-S88DOI: ( /j.surneu ) Copyright © 2005 Elsevier Inc. Terms and Conditions
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Fig. 1 Stereotactic CT-MRI image fusion in a case with pineal region tumors. A: Three-dimensional display of the trajectory of the cannula. B: Preoperative stereotactic surgical planning on multiplanar MRI-fused image program. C: Probe view of the virtual biopsy trajectory in the tumor. D: The probe-view images provide critical surgical information: the trajectory is far away from the internal cerebral veins and other vascular structures. The biopsy tract should stay within the limits of −10 and 10 mm according to the targeted center of the tumor; cisternal and vascular structures at the pineal region may be damaged after +10 mm; no more tumor tissue at 15 mm. Surgical Neurology , S82-S88DOI: ( /j.surneu ) Copyright © 2005 Elsevier Inc. Terms and Conditions
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Fig. 2 SB microforceps with 1.4-mm spoon diameter.
Surgical Neurology , S82-S88DOI: ( /j.surneu ) Copyright © 2005 Elsevier Inc. Terms and Conditions
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Fig. 3 A case in whom there was a discrepancy between SP and paraffin diagnosis because of the presence of necrosis. A: SP demonstrated only massive necrosis (H&E, original magnification ×200). B: One of the paraffin-embedded serial biopsies also showed only necrosis (H&E, original magnification ×400). C: The remaining biopsy specimens showed a glioblastoma multiforme characterized by neurofibrillary background and pleomorphic atypical glial cells (H&E, original magnification ×400). Surgical Neurology , S82-S88DOI: ( /j.surneu ) Copyright © 2005 Elsevier Inc. Terms and Conditions
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Fig. 4 A case in whom there was a discrepancy between SP and paraffin diagnosis because of the improper quality of the preparation. A: The thick improper SP with monotonous cells with round nucleus and rosettelike structures admixed within background of erythrocytes, which was interpreted as ependymoma (H&E, original magnification ×400). B: The paraffin-embedded biopsy specimen of the same case showed cells with uniform, small round nuclei surrounded by clear halos on a neurofibrillary background and diagnosed as oligodendroglioma (H&E, original magnification ×200). Surgical Neurology , S82-S88DOI: ( /j.surneu ) Copyright © 2005 Elsevier Inc. Terms and Conditions
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