Talk:Neuropathology

AVM

Microscopic

The section shows numerous large veins that have thickened walls and arteries with intervening brain parenchyma. There is a small focus of monocytoid cells, hemosiderin-laden macrophages and necrosis consistent with prior bleeding.

Diagnosis

BRAIN, RIGHT TEMPORAL:
- ARTERIOVENOUS MALFORMATION.
- NEGATIVE FOR MALIGNANCY.

CADASIL

Microscopic

The biopsy, containing epidermis, dermis and subcutaneous tissue, is technically satisfactory. Immunostains utilizing a monoclonal antibody 1E4 (anti-Notch-3) at dilution 1:50 shows the absence of granular deposits in the walls of small arteries and veins in the dermis and subcutaneous tissue. Immunostains are strongly positive on positive control tissue from a patient known to have CADASIL.

Final diagnosis

SKIN, BIOPSY:
- ABSENCE OF NOTCH-3 IMMUNOSTAINING.

Reactive gliosis

Microscopic

The section shows white matter and grey matter with regions of increased cellularity, consisting predominantly of regularily-spaced (glial) cells with bland-appearing, uniform, non-oviod nuclei. Glial cells, focally, have fine, eosinophilic, branching processes. A small subset of cells have moderate nuclear enlargement.

Numerous axonal swellings are noted. There is no mitotic activity and no necrosis. No calcifications are identified.

Diagnosis

BRAIN:
-REACTIVE GLIOSIS.