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[[Image:Tuber HE 20191014 011.jpg|thumb|right|[[Micrograph]] showing a cortical tuber. [[H&E stain]]. (WC/ | [[Image:Tuber HE 20191014 011.jpg|thumb|right|[[Micrograph]] showing a cortical tuber. [[H&E stain]]. (WC/jensflorian]] | ||
'''Cortical tubers''' are malformative lesions in the CNS observed in '''tuberous sclerosis complex''' (abbreviated '''TSC'''), an autosomal dominant [[syndrome]]. | '''Cortical tubers''' are malformative lesions in the CNS observed in '''tuberous sclerosis complex''' (abbreviated '''TSC'''), an autosomal dominant [[syndrome]]. | ||
==General== | ==General== | ||
*Cortical tubers are malformative, epilepsy-associated.<ref>{{Cite journal | last1 = Cotter | first1 = JA. | title = An update on the central nervous system manifestations of tuberous sclerosis complex. | journal = Acta Neuropathol | volume = | issue = | pages = | month = Apr | year = 2019 | doi = 10.1007/s00401-019-02003-1 | PMID = 30976976 }}</ref> | |||
*Seen in 80-90% of the TSC cases. | |||
*Gyrus is usu. thickened, raised, and occasionally dimpled. | |||
*Giant cells, dysmorphic neurons, gliosis, calcifications. | |||
*Prominent cell loss in all cortical layers.<ref>{{Cite journal | last1 = Mühlebner | first1 = A. | last2 = Iyer | first2 = AM. | last3 = van Scheppingen | first3 = J. | last4 = Anink | first4 = JJ. | last5 = Jansen | first5 = FE. | last6 = Veersema | first6 = TJ. | last7 = Braun | first7 = KP. | last8 = Spliet | first8 = WG. | last9 = van Hecke | first9 = W. | title = Specific pattern of maturation and differentiation in the formation of cortical tubers in tuberous sclerosis omplex (TSC): evidence from layer-specific marker expression. | journal = J Neurodev Disord | volume = 8 | issue = | pages = 9 | month = | year = 2016 | doi = 10.1186/s11689-016-9142-0 | PMID = 27042238 }}</ref> | |||
*Normal cortical lamination is lost in the lesion. | |||
*TSC2 has larger and more numerous tubers.<ref>{{Cite journal | last1 = Overwater | first1 = IE. | last2 = Swenker | first2 = R. | last3 = van der Ende | first3 = EL. | last4 = Hanemaayer | first4 = KB. | last5 = Hoogeveen-Westerveld | first5 = M. | last6 = van Eeghen | first6 = AM. | last7 = Lequin | first7 = MH. | last8 = van den Ouweland | first8 = AM. | last9 = Moll | first9 = HA. | title = Genotype and brain pathology phenotype in children with tuberous sclerosis complex. | journal = Eur J Hum Genet | volume = 24 | issue = 12 | pages = 1688-1695 | month = 12 | year = 2016 | doi = 10.1038/ejhg.2016.85 | PMID = 27406250 }}</ref> | |||
==IHC== | |||
*Ballon cells are Vim+ve, MAP2+ve, Nestin+ve, GFAP+/-ve, NeuN+/-ve. | |||
<gallery> | |||
File:Tuber_GFAP_20191014_012.jpg|GFAP sparing dysmorphic ballon cells. | |||
</gallery> | |||
== | ==Imaging== | ||
Examples on Radiopedia [[https://radiopaedia.org/articles/cortical-tubers]] | |||
==DDx== | |||
* [[Focal cortical dysplasia]] ILAE type IIB (Tubers are usu. multifocal). | |||
==See also== | ==See also== | ||
[[Tuberous sclerosis]] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category: | [[Category:Malformation]] | ||
[[Category:Neuropathology]] | [[Category:Neuropathology]] | ||