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==Brain tumours - overview== | ==Brain tumours - overview== | ||
===Adult=== | ===Alphabetical=== | ||
For overview see [[:Category:Neuropathology_tumours|here]] | |||
===By age group=== | |||
====Adult==== | |||
Four most common types of brain tumours:<ref>[http://neurosurgery.mgh.harvard.edu/abta/primer.htm http://neurosurgery.mgh.harvard.edu/abta/primer.htm]</ref> | Four most common types of brain tumours:<ref>[http://neurosurgery.mgh.harvard.edu/abta/primer.htm http://neurosurgery.mgh.harvard.edu/abta/primer.htm]</ref> | ||
# Metastatic brain tumours (barely edges out primary tumours) | # Metastatic brain tumours (barely edges out primary tumours) | ||
| Line 16: | Line 20: | ||
# [[Meningioma]]. | # [[Meningioma]]. | ||
===Children=== | ====Children==== | ||
# Pilocytic astrocytoma. | # [[Pilocytic astrocytoma]]. | ||
# [[Medulloblastoma]]. | # [[Medulloblastoma]]. | ||
# [[Ependymoma]]. | # [[Ependymoma]]. | ||
| Line 23: | Line 27: | ||
===Location (most common)=== | ===Location (most common)=== | ||
Certain tumours like to hang-out at certain places:<ref>URL: [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif] and [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html]. Accessed on: 2 November 2010.</ref> | Certain tumours like to hang-out at certain places:<ref>URL: [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif] and [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html]. Accessed on: 2 November 2010.</ref> | ||
====Cerebrum==== | |||
**Cortical based - [[oligodendroglioma]]. | **Cortical based - [[oligodendroglioma]]. | ||
**Grey-white junction - metastases. | **Grey-white junction - metastases. | ||
| Line 29: | Line 33: | ||
**Periventricular - CNS lymphoma. | **Periventricular - CNS lymphoma. | ||
**Cystic - [[ganglioglioma]], [[pilocytic astrocytoma]], [[pleomorphic xanthoastrocytoma]]. | **Cystic - [[ganglioglioma]], [[pilocytic astrocytoma]], [[pleomorphic xanthoastrocytoma]]. | ||
====Cerebellum==== | |||
**Midline/central - [[medulloblastoma]]. | **Midline/central - [[medulloblastoma]]. | ||
**Cystic lesion - pilocytic astrocytoma (younger individual), [[hemangioblastoma]] (older individual). | **Cystic lesion - pilocytic astrocytoma (younger individual), [[hemangioblastoma]] (older individual). | ||
**Solid lesion (older individual) - [[metastasis]]. | **Solid lesion (older individual) - [[metastasis]]. | ||
====Spinal cord==== | |||
**[[Ependymoma]], glioblastoma. | **[[Ependymoma]], glioblastoma. | ||
**Filum terminale - [[myxopapillary ependymoma]], [[paraganglioma]]. | **Filum terminale - [[myxopapillary ependymoma]], [[paraganglioma]]. | ||
====Filum terminale==== | ====Filum terminale==== | ||
*Filum terminale = bottom end of the spinal cord - has a limited differential. | *Filum terminale = bottom end of the spinal cord - has a limited differential. | ||
DDx:<ref>JLK. 31 May 2010.</ref> | DDx:<ref>JLK. 31 May 2010.</ref> | ||
*[[Meningioma]]. | *[[Meningioma]]. | ||
| Line 49: | Line 51: | ||
====Cerebellopontine angle==== | ====Cerebellopontine angle==== | ||
*Abbreviated ''CP angle''. | *Abbreviated ''CP angle''. | ||
DDx:<ref>R. Kiehl. 8 November 2010.</ref> | DDx:<ref>R. Kiehl. 8 November 2010.</ref> | ||
*[[Schwannoma]]. | *[[Schwannoma]]. | ||
| Line 248: | Line 249: | ||
*IDH1 and IDH2 mutations - better survival.<ref name=pmid20975057>{{cite journal |author=Houillier C, Wang X, Kaloshi G, ''et al.'' |title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas |journal=Neurology |volume=75 |issue=17 |pages=1560–6 |year=2010 |month=October |pmid=20975057 |doi=10.1212/WNL.0b013e3181f96282 |url=}}</ref> | *IDH1 and IDH2 mutations - better survival.<ref name=pmid20975057>{{cite journal |author=Houillier C, Wang X, Kaloshi G, ''et al.'' |title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas |journal=Neurology |volume=75 |issue=17 |pages=1560–6 |year=2010 |month=October |pmid=20975057 |doi=10.1212/WNL.0b013e3181f96282 |url=}}</ref> | ||
== | ==Astrocytic tumours== | ||
{{Main| | {{Main|Astrocytoma}} | ||
* Diffuse [[Astrocytoma]] | |||
* [[Anaplastic astrocytoma]] | |||
* [[Glioblastoma]] | |||
* [[Gliomatosis cerebri]] | |||
* [[Pilocytic astrocytoma]] (PA) | |||
* [[Pilomyxoid astrocytoma]] (PMA) | |||
* [[Pleomorphic xanthoastrocytoma]] (PXA) | |||
* [[Subependymal giant cell astrocytoma]] (SEGA) | |||
== | ==Oligodendroglial tumours== | ||
* | * [[Oligodendroglioma]] | ||
* Anaplastic oligodendroglioma | |||
* [[Oligoastrocytoma]] | |||
* Anaplastic oligoastrocytoma | |||
== | ==Ependymal tumours== | ||
* | * [[Subependymoma]] | ||
* [[Myxopapillary Ependymoma]] | |||
* [[Ependymoma]] | |||
* Anaplastic ependymoma | |||
== | ==Choroid plexus tumours== | ||
* [[Choroid plexus papilloma]] | |||
* Atypical choroid plexus papilloma | |||
* [[Choroid plexus carcinoma]] | |||
== | ==Other neuroepithelial tumours== | ||
* Astroblastoma | |||
* Chordoid glioma of the third ventricle | |||
* [[Angiocentric glioma]] | |||
== | ===Astroblastoma=== | ||
*No WHO grade yet. | |||
*Very rare superficial tumor of young age. | |||
*Large, cystic. Pushing margin towards CNS. | |||
*Vasocentric growth, plump cells with absence of fibrillary pattern. | |||
*GFAP+ve, Synaptohysin-ve, focally EMA/panCK+ve. MIB-1: 1-18 %. | |||
<gallery> | |||
File:Astroblastoma_HE_Specimen.jpg | HE. (WC/jensflorian) | |||
File:Astroblastoma_HE_papillae.jpg | HE. (WC/jensflorian) | |||
File:Astroblastoma.jpg | Astroblastoma (AFIP) | |||
</gallery> | |||
==Chordoid glioma of the | ===Chordoid glioma of the third ventricle=== | ||
* WHO grade II. | * WHO grade II. | ||
* Slowly growing, non-invasive. | * Slowly growing, non-invasive. | ||
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* GFAP+ve, MIB-1 1-3%. | * GFAP+ve, MIB-1 1-3%. | ||
==Gangliocytoma== | ==Neuronal and mixed neuronal/glial tumours== | ||
* Desmoplastic infantile astrocytoma / ganglioglioma (DIA/DIG) | |||
* [[Dysembryoplastic neuroepithelial tumour]] | |||
* [[Central Neurocytoma]] / Extraventricular [[neurocytoma]] | |||
* Cerebellar liponeurocytoma | |||
* Papillary glioneuronal tumour | |||
* Rosette-forming glioneuronal tumour of the fourth ventricle | |||
* Gangliocytoma / Ganglioglioma | |||
* Dysplastic ganglioglioma of the cerebellum (Lhermitte-Duclos) | |||
* [[Paraganglioma]] | |||
===Gangliocytoma=== | |||
* Grade I WHO neuronal tumour. | * Grade I WHO neuronal tumour. | ||
** ICD-O code: 9492/0 | ** ICD-O code: 9492/0 | ||
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* Non-neoplastic, reticulin-rich glial stroma. | * Non-neoplastic, reticulin-rich glial stroma. | ||
==Ganglioglioma== | ===Ganglioglioma=== | ||
:'''Not''' to be confused with ''[[ganglioneuroma]]''. | :'''Not''' to be confused with ''[[ganglioneuroma]]''. | ||
===General=== | ====General==== | ||
*Grade I WHO mixed neuronal-glial tumour. | *Grade I WHO mixed neuronal-glial tumour. | ||
*ICD-O code: 9505/1 (Anaplastic ganglioglioma: 9505/3) | *ICD-O code: 9505/1 (Anaplastic ganglioglioma: 9505/3) | ||
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*Recognized as a cause of [[epilepsy]].<ref name=pmid12125968>{{Cite journal | last1 = Im | first1 = SH. | last2 = Chung | first2 = CK. | last3 = Cho | first3 = BK. | last4 = Lee | first4 = SK. | title = Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome. | journal = J Neurooncol | volume = 57 | issue = 1 | pages = 59-66 | month = Mar | year = 2002 | doi = | PMID = 12125968 }}</ref> | *Recognized as a cause of [[epilepsy]].<ref name=pmid12125968>{{Cite journal | last1 = Im | first1 = SH. | last2 = Chung | first2 = CK. | last3 = Cho | first3 = BK. | last4 = Lee | first4 = SK. | title = Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome. | journal = J Neurooncol | volume = 57 | issue = 1 | pages = 59-66 | month = Mar | year = 2002 | doi = | PMID = 12125968 }}</ref> | ||
===Microscopic=== | ====Microscopic==== | ||
Features: | Features: | ||
*Dysplastic neurons. | *Dysplastic neurons. | ||
| Line 325: | Line 344: | ||
*Necrosis | *Necrosis | ||
===IHC=== | ====IHC==== | ||
*Neurons: | *Neurons: | ||
**[[MAP2]] +ve | **[[MAP2]] +ve | ||
| Line 333: | Line 352: | ||
**CD34+/-ve | **CD34+/-ve | ||
===DDx:=== | ====DDx:==== | ||
*[[DNT]]. | *[[DNT]]. | ||
*[[Oligodendroglioma]]. | *[[Oligodendroglioma]]. | ||
*Trapped cortical neurons in diffuse astrocytoma. | *Trapped cortical neurons in diffuse astrocytoma. | ||
===Images=== | ====Images==== | ||
<gallery> | <gallery> | ||
File:Ganglioglioma lymphocytic cuffing PAS.jpg | Lymphocytic cuffing in ganglioglioma (WC/jensflorian) | File:Ganglioglioma lymphocytic cuffing PAS.jpg | Lymphocytic cuffing in ganglioglioma (WC/jensflorian) | ||
| Line 347: | Line 366: | ||
*[http://path.upmc.edu/cases/case282.html Ganglioglioma - case 2 (upmc.edu)]. | *[http://path.upmc.edu/cases/case282.html Ganglioglioma - case 2 (upmc.edu)]. | ||
===Lhermitte-Duclos disease=== | |||
*Abbreviated ''LDD''. | |||
*[[AKA]] ''dysplastic cerebellar gangliocytoma''.<ref name=pmid20060133>{{Cite journal | last1 = Yağci-Küpeli | first1 = B. | last2 = Oguz | first2 = KK. | last3 = Bilen | first3 = MA. | last4 = Yalçin | first4 = B. | last5 = Akalan | first5 = N. | last6 = Büyükpamukçu | first6 = M. | title = An unusual cause of posterior fossa mass: Lhermitte-Duclos disease. | journal = J Neurol Sci | volume = 290 | issue = 1-2 | pages = 138-41 | month = Mar | year = 2010 | doi = 10.1016/j.jns.2009.12.010 | PMID = 20060133 }}</ref> | |||
*[[AKA]] ''dysplastic gangliocytoma of the cerebellum''. | |||
{{Main|Lhermitte-Duclos disease}} | |||
== | ==Pineal tumours== | ||
{{Main|Pineal gland}} | |||
{{Main| | |||
* [[Pineocytoma]] | |||
* [[Pineal parenchymal tumour of intermediate differentiation]] | |||
* | * [[Pineoblastoma]] | ||
* | * [[Papillary tumour of the pineal region]] | ||
== | ==Embryonal tumours== | ||
* [[Atypical teratoid/rhabdoid tumour]] (AT/RT) or (AT-RT) | |||
* [[Medulloblastoma]] | |||
* [[Primitive neuroectodermal tumour]] (PNET) | |||
* | * [[Embryonal tumour with abundant neuropil and true rosettes]] (ETANTR) | ||
==Peripheral nerve sheath tumours== | ==Peripheral nerve sheath tumours== | ||
{{Main|Peripheral nerve sheath tumours}} | {{Main|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:''' | |||
*[[Schwannoma]]. | |||
*[[Neurofibroma]]. | |||
*[[Perineurioma]]. | |||
*Ganglioneuroma. | |||
**[[Traumatic neuroma]]. | **[[Traumatic neuroma]]. | ||
'''Malignant:''' | |||
*[[Malignant peripheral nerve sheath tumour]] (MPNST). | |||
==Ganglioneuroma== | ===Ganglioneuroma=== | ||
:'''Not''' to be confused with ''[[ganglioglioma]]''. | :'''Not''' to be confused with ''[[ganglioglioma]]''. | ||
*[[AKA]] ganglioma.<ref>URL: [http://medical-dictionary.thefreedictionary.com/ganglioma http://medical-dictionary.thefreedictionary.com/ganglioma]. Accessed on: 8 November 2010.</ref> | *[[AKA]] ganglioma.<ref>URL: [http://medical-dictionary.thefreedictionary.com/ganglioma http://medical-dictionary.thefreedictionary.com/ganglioma]. Accessed on: 8 November 2010.</ref> | ||
{{Main|Ganglioneuroma}} | {{Main|Ganglioneuroma}} | ||
==Meningioma== | |||
{{Main|Meningioma}} | |||
==Chordoma== | ==Chordoma== | ||
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*Bcl-6 +ve. | *Bcl-6 +ve. | ||
*Bcl-1 -ve. | *Bcl-1 -ve. | ||
==Ganglioneuroblastoma== | ==Ganglioneuroblastoma== | ||