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Difference between revisions of "Pineal gland"
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==Overview== | ==Overview== | ||
Non-neoplastic: | |||
* Cysts | |||
Tumours:<ref name=pmid20971711>{{cite journal |author=Gaillard F, Jones J |title=Masses of the pineal region: clinical presentation and radiographic features |journal=Postgrad Med J |volume=86 |issue=1020 |pages=597–607 |year=2010 |month=October |pmid=20971711 |doi=10.1136/pgmj.2009.087460 |url=}}</ref> | Tumours:<ref name=pmid20971711>{{cite journal |author=Gaillard F, Jones J |title=Masses of the pineal region: clinical presentation and radiographic features |journal=Postgrad Med J |volume=86 |issue=1020 |pages=597–607 |year=2010 |month=October |pmid=20971711 |doi=10.1136/pgmj.2009.087460 |url=}}</ref> | ||
*Primary pineal tumours ~15% of (pineal) tumours - benign to malignant:<ref name=pmid21057132>{{cite journal |author=Smith AB, Rushing EJ, Smirniotopoulos JG |title=From the archives of the AFIP: lesions of the pineal region: radiologic-pathologic correlation |journal=Radiographics |volume=30 |issue=7 |pages=2001–20 |year=2010 |month=November |pmid=21057132 |doi=10.1148/rg.307105131 |url=}}</ref> | *Primary pineal tumours ~15% of (pineal) tumours - benign to malignant:<ref name=pmid21057132>{{cite journal |author=Smith AB, Rushing EJ, Smirniotopoulos JG |title=From the archives of the AFIP: lesions of the pineal region: radiologic-pathologic correlation |journal=Radiographics |volume=30 |issue=7 |pages=2001–20 |year=2010 |month=November |pmid=21057132 |doi=10.1148/rg.307105131 |url=}}</ref> | ||
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**[[Meningioma]]s. | **[[Meningioma]]s. | ||
== | ==Pineal gland cyst== | ||
*Quite common. <ref name=pmid17885233> {{Cite journal | last1 = Pu | first1 = Y. | last2 = Mahankali | first2 = S. | last3 = Hou | first3 = J. | last4 = Li | first4 = J. | last5 = Lancaster | first5 = JL. | last6 = Gao | first6 = JH. | last7 = Appelbaum | first7 = DE. | last8 = Fox | first8 = PT. | title = High prevalence of pineal cysts in healthy adults demonstrated by high-resolution, noncontrast brain MR imaging. | journal = AJNR Am J Neuroradiol | volume = 28 | issue = 9 | pages = 1706-9 | month = Oct | year = 2007 | doi = 10.3174/ajnr.A0656 | PMID = 17885233 }}</ref> | |||
*large cysts can cause CSF obstruction. <ref>{{Cite journal | last1 = Mena | first1 = H. | last2 = Armonda | first2 = RA. | last3 = Ribas | first3 = JL. | last4 = Ondra | first4 = SL. | last5 = Rushing | first5 = EJ. | title = Nonneoplastic pineal cysts: a clinicopathologic study of twenty-one cases. | journal = Ann Diagn Pathol | volume = 1 | issue = 1 | pages = 11-8 | month = Oct | year = 1997 | doi = | PMID = 9869821 }}</ref> | |||
<gallery> | |||
File:Pinealiszyste.jpg | Pineal gland cyst found at autopsy. (WC/Marvin101) | |||
File:Pineal_gland_cyst_low_mag_HE.jpg | Pineal gland cyst. HE, low mag. (WC/jensflorian) | |||
File:Pineal_gland_cyst_highmagnification_HE.jpg | Pineal gland cyst. HE, higher mag. (WC/jensflorian) | |||
</gallery> | |||
==Pineocytoma== | ==Pineocytoma== | ||
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*Usually no pinecytomatous rosettes. | *Usually no pinecytomatous rosettes. | ||
*High pleomorphism possible. | *High pleomorphism possible. | ||
===Molecular=== | |||
* Insertions in KBTBD4.<ref name="pmid31768671">{{cite journal |authors=Pfaff E, Aichmüller C, Sill M, Stichel D, Snuderl M, Karajannis MA, Schuhmann MU, Schittenhelm J, Hasselblatt M, Thomas C, Korshunov A, Rhizova M, Wittmann A, Kaufhold A, Iskar M, Ketteler P, Lohmann D, Orr BA, Ellison DW, von Hoff K, Mynarek M, Rutkowski S, Sahm F, von Deimling A, Lichter P, Kool M, Zapatka M, Pfister SM, Jones DTW |title=Molecular subgrouping of primary pineal parenchymal tumors reveals distinct subtypes correlated with clinical parameters and genetic alterations |journal=Acta Neuropathol |volume=139 |issue=2 |pages=243–257 |date=February 2020 |pmid=31768671 |doi=10.1007/s00401-019-02101-0 |url=}}</ref> | |||
Images: | Images: | ||
| Line 84: | Line 99: | ||
</gallery> | </gallery> | ||
==Papillary | ==Papillary tumour of pineal region (PTPR)== | ||
===General=== | ===General=== | ||
*Very rare neuoepithelial tumor of adults. | *Very rare neuoepithelial tumor of adults. | ||
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* EMA mostly -ve. | * EMA mostly -ve. | ||
* NF and Kir 7.1-ve. | * NF and Kir 7.1-ve. | ||
===Molecular=== | |||
* PTEN alterations. <ref name="pmid26113311">{{cite journal |authors=Heim S, Sill M, Jones DT, Vasiljevic A, Jouvet A, Fèvre-Montange M, Wesseling P, Beschorner R, Mittelbronn M, Kohlhof P, Hovestadt V, Johann P, Kool M, Pajtler KW, Korshunov A, Ruland V, Sperveslage J, Thomas C, Witt H, von Deimling A, Paulus W, Pfister SM, Capper D, Hasselblatt M |title=Papillary Tumor of the Pineal Region: A Distinct Molecular Entity |journal=Brain Pathol |volume=26 |issue=2 |pages=199–205 |date=March 2016 |pmid=26113311 |doi=10.1111/bpa.12282 |url=}}</ref> | |||
*Chromosome 10 loss. | |||
DDx: | DDx: | ||
| Line 135: | Line 154: | ||
*Males > females. | *Males > females. | ||
*Children & young adults. | *Children & young adults. | ||
*Corresponds to WHO IV (ICD-O: 9362/3) | *Corresponds to WHO IV (ICD-O: 9362/3). | ||
*May be a manifestation of the [[DICER1 syndrome]].<ref name=pmid28960912>{{Cite journal | last1 = van Engelen | first1 = K. | last2 = Villani | first2 = A. | last3 = Wasserman | first3 = JD. | last4 = Aronoff | first4 = L. | last5 = Greer | first5 = MC. | last6 = Tijerin Bueno | first6 = M. | last7 = Gallinger | first7 = B. | last8 = Kim | first8 = RH. | last9 = Grant | first9 = R. | title = DICER1 syndrome: Approach to testing and management at a large pediatric tertiary care center. | journal = Pediatr Blood Cancer | volume = 65 | issue = 1 | pages = | month = Jan | year = 2018 | doi = 10.1002/pbc.26720 | PMID = 28960912 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
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*Synaptophysin+ve | *Synaptophysin+ve | ||
*MIB-1: high. | *MIB-1: high. | ||
===Molecular=== | |||
* DICER1 mutations.<ref name="pmid25022261">{{cite journal |authors=de Kock L, Sabbaghian N, Druker H, Weber E, Hamel N, Miller S, Choong CS, Gottardo NG, Kees UR, Rednam SP, van Hest LP, Jongmans MC, Jhangiani S, Lupski JR, Zacharin M, Bouron-Dal Soglio D, Huang A, Priest JR, Perry A, Mueller S, Albrecht S, Malkin D, Grundy RG, Foulkes WD |title=Germ-line and somatic DICER1 mutations in pineoblastoma |journal=Acta Neuropathol |volume=128 |issue=4 |pages=583–95 |date=October 2014 |pmid=25022261 |pmc=4381868 |doi=10.1007/s00401-014-1318-7 |url=}}</ref> | |||
*DROSHA deletions. <ref name="pmid30877433">{{cite journal |authors=Lee JC, Mazor T, Lao R, Wan E, Diallo AB, Hill NS, Thangaraj N, Wendelsdorf K, Samuel D, Kline CN, Banerjee A, Auguste K, Raffel C, Gupta N, Berger M, Raleigh DR, Shai A, Phillips JJ, Bollen AW, Tihan T, Perry A, Costello J, Solomon DA |title=Recurrent KBTBD4 small in-frame insertions and absence of DROSHA deletion or DICER1 mutation differentiate pineal parenchymal tumor of intermediate differentiation (PPTID) from pineoblastoma |journal=Acta Neuropathol |volume=137 |issue=5 |pages=851–854 |date=May 2019 |pmid=30877433 |pmc=6483828 |doi=10.1007/s00401-019-01990-5 |url=}}</ref> | |||
DDx: | DDx: | ||