Difference between revisions of "Neuropathology tumours"

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==Astrocytomas==  
==Astrocytomas==  
*pilocytic astrocytomas (WHO Grade I),
*Pilocytic astrocytomas (WHO Grade I).
*dysembryoplastic neuroepithelial tumour (DNT), (WHO Grade I)
*Dysembryoplastic neuroepithelial tumour (DNT), (WHO Grade I).
*low-grade (diffuse) astrocytomas (Grade II),
*Low-grade (diffuse) astrocytomas (Grade II).
*anaplastic astrocytomas (Grade III),
*Anaplastic astrocytomas (Grade III).
*glioblastoma (Grade IV);
*Glioblastoma (Grade IV).


Features:<ref name=pmid>{{cite journal |author=Rong Y, Durden DL, Van Meir EG, Brat DJ |title='Pseudopalisading' necrosis in glioblastoma: a familiar morphologic feature that links vascular pathology, hypoxia, and angiogenesis |journal=J. Neuropathol. Exp. Neurol. |volume=65 |issue=6 |pages=529–39 |year=2006 |month=June |pmid=16783163 |doi= |url=}}</ref><ref>[http://dictionary.reference.com/browse/palisading http://dictionary.reference.com/browse/palisading]</ref>
Features:<ref name=pmid>{{cite journal |author=Rong Y, Durden DL, Van Meir EG, Brat DJ |title='Pseudopalisading' necrosis in glioblastoma: a familiar morphologic feature that links vascular pathology, hypoxia, and angiogenesis |journal=J. Neuropathol. Exp. Neurol. |volume=65 |issue=6 |pages=529–39 |year=2006 |month=June |pmid=16783163 |doi= |url=}}</ref><ref>[http://dictionary.reference.com/browse/palisading http://dictionary.reference.com/browse/palisading]</ref>
*Nuclear pleomorphism,
*Nuclear pleomorphism.
*Mitotic figures,
*Mitotic figures.
*Microvascular proliferation or necrosis with pseudopalisading tumour cells.
*Microvascular proliferation or necrosis with pseudopalisading tumour cells.
**Pseudopalisading tumour cells = high tumour cell density adjacent to regions of necrosis; palisade = a fence of pales forming a defense barrier or fortification.
**Pseudopalisading tumour cells = high tumour cell density adjacent to regions of necrosis; palisade = a fence of pales forming a defense barrier or fortification.


==Pilocytic astrocytoma==
==Pilocytic astrocytoma==
Gross
Gross:
*Do NOT smear.
*Do NOT smear.


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==Peripheral nerve sheath tumours==
==Peripheral nerve sheath tumours==
A classification:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref>
A classification:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref>
*Benign
*Benign:
**Schwannoma
**Schwannoma.
**Neurofibroma
**Neurofibroma.
**Perineurioma
**Perineurioma.
**Traumatic neuroma
**Traumatic neuroma.
*Malignant
*Malignant:
**Malignant peripheral nerve sheath tumour (MPNST)
**Malignant peripheral nerve sheath tumour (MPNST).


==Schwannoma==
==Schwannoma==
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====Antoni A====
====Antoni A====
*Cellular.
*Cellular.
*'fibrillary, polar, elongated'.
*'Fibrillary, polar, elongated'.


Comment: May look somewhat like scattered matchsticks.
Comment: May look somewhat like scattered matchsticks.
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*Papillae.
*Papillae.
*Psammoma bodies.
*Psammoma bodies.


==References==
==References==

Revision as of 12:17, 17 May 2010

The article covers CNS tumours, including Brain tumours. They are relatively common and mostly real badness. Tumours are a large part of neuropathology.

The article also includes peripheral nerve sheath tumours.

Brain tumours

Adult

Four most common types of brain tumours:[1]

  1. Metastatic brain tumours (barely edges out primary tumours)
  2. Glioblastoma aka glioblastoma multiforme.
  3. Anaplastic (malignant) astrocytoma.
  4. Meningioma.

Children

  1. Astrocytoma.
  2. Medulloblastoma.
  3. Ependymoma.

Astrocytomas

  • Pilocytic astrocytomas (WHO Grade I).
  • Dysembryoplastic neuroepithelial tumour (DNT), (WHO Grade I).
  • Low-grade (diffuse) astrocytomas (Grade II).
  • Anaplastic astrocytomas (Grade III).
  • Glioblastoma (Grade IV).

Features:[2][3]

  • Nuclear pleomorphism.
  • Mitotic figures.
  • Microvascular proliferation or necrosis with pseudopalisading tumour cells.
    • Pseudopalisading tumour cells = high tumour cell density adjacent to regions of necrosis; palisade = a fence of pales forming a defense barrier or fortification.

Pilocytic astrocytoma

Gross:

  • Do NOT smear.

Micro.

  • Rosenthal fibres - key feature.

DDx (of Rosenthal fibers):[4]

  • Chronic reactive gliosis.
  • Subependymoma.
  • Ganglioma.
  • Alexander's disease (rare leukodystrophy).

Oligodendroglial tumours

Arise from oligodendrocytes.

Micro

  • Calcifications.[5] - key feature.
  • Oligodendrocytes.
    • Cells with clear cytoplasm.
  • Abundant delicate vessels (may vagues resemble paraganglioma at low power).

Peripheral nerve sheath tumours

A classification:[6]

  • Benign:
    • Schwannoma.
    • Neurofibroma.
    • Perineurioma.
    • Traumatic neuroma.
  • Malignant:
    • Malignant peripheral nerve sheath tumour (MPNST).

Schwannoma

  • Tumour of tissue surrounding a nerve.
    • Axons adjacent to the tumour are normal... but may be compressed.

Histology

Antoni tissue:[6]

Antoni A

  • Cellular.
  • 'Fibrillary, polar, elongated'.

Comment: May look somewhat like scattered matchsticks.

Antoni B

  • Loose microcystic tissue.
  • Adjacent to Antoni A.

Micrographs:

Neurofibroma

General:[6]

  • Composed of Schwann cells, axons, fibrous material.

Appearance/morphology:[6]

  • Plexiform growth pattern - "bag of worms".

Ependymoma

Microscopy

Features:

  • Cells have a "tadpole-like" morphology.
    • May also be described as ice cream cone-shaped.[7]
  • Rosettes - cells arranged in a pseudoglandular fashion.
  • "Nucleus free zones" - cells arranged around a blood vessel (pseudorosettes) - vessel not seen, only cytoplasm of tumour cells.
    • The nucleus free zone is composed of tumour cell cytoplasm that is adjacent to an unseen blood vessel.
  • Nuclear feature monotonous, i.e. "boring".[8]

DDx:

  • Subependymoma.

Choriod plexus papilloma

Microscopy

Features:

  • Papillae.
  • Psammoma bodies.

References

  1. ↑ http://neurosurgery.mgh.harvard.edu/abta/primer.htm
  2. ↑ Rong Y, Durden DL, Van Meir EG, Brat DJ (June 2006). "'Pseudopalisading' necrosis in glioblastoma: a familiar morphologic feature that links vascular pathology, hypoxia, and angiogenesis". J. Neuropathol. Exp. Neurol. 65 (6): 529–39. PMID 16783163.
  3. ↑ http://dictionary.reference.com/browse/palisading
  4. ↑ MUN 9 Mar 2009
  5. ↑ http://www.emedicine.com/radio/topic481.htm
  6. ↑ 6.0 6.1 6.2 6.3 Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A (October 2007). "Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns". AJNR Am J Neuroradiol 28 (9): 1633–8. doi:10.3174/ajnr.A0682. PMID 17893219. http://www.ajnr.org/cgi/reprint/28/9/1633.
  7. ↑ http://www.pathology.vcu.edu/WirSelfInst/tumor-2.html
  8. ↑ MUN. 6 Oct 2009.

External links

Retrieved from "https://librepathology.org/w/index.php?title=Neuropathology_tumours&oldid=188"