Difference between revisions of "Neuropathology tumours"

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Neuropathology tumours (view source)

Revision as of 16:47, 13 January 2011

582 bytes removed ,  16:47, 13 January 2011
split-out gliosarcoma
(split-out gliosarcoma)
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*[http://commons.wikimedia.org/wiki/File:Metastatic_adenocarcinoma_-_cerebellum_-_high_mag.jpg CRC metastasis to cerebellum - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Metastatic_adenocarcinoma_-_cerebellum_-_high_mag.jpg CRC metastasis to cerebellum - high mag. (WC)].


==Astrocytomas==  
==Infiltrative astrocytomas==  
{{Main|Astrocytoma}}
 
===Overview===
===Overview===
*Pilocytic astrocytomas (WHO Grade I).  
*Pilocytic astrocytomas (WHO Grade I).  
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====Grading====
====Grading====
At least grade II:
At least grade II (diffuse astrocytoma):
*Nuclear pleomorphism.
*Nuclear pleomorphism.


At least grade III:
At least grade III (anaplastic astrocytoma):
*Mitotic figures.  
*Mitotic figures.  


At least grade IV:
At least grade IV (glioblastoma [[AKA]] glioblastoma multiforme):
*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.


===Glioblastoma IHC===
Images:
*Glioblastoma:
**[http://commons.wikimedia.org/wiki/File:Glioblastoma_%281%29.jpg Glioblastoma - pseudopalisading of tumour cells (WC)].
**[http://commons.wikimedia.org/wiki/File:Glioblastoma_-_high_mag.jpg Glioblastoma with fragment of near-normal white matter - high mag. (WC)].
*Anaplastic astrocytoma:
**[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg Anaplastic astrocytoma - very high mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_gfap_-_very_high_mag.jpg Anaplastic astrocytoma - GFAP - very high mag. (WC)].
 
===IHC===
*GFAP - should stain cytoplasm of tumour cells and the perikaryon (nuclear membrane).
*GFAP - should stain cytoplasm of tumour cells and the perikaryon (nuclear membrane).
*Ki-67 - usu. high >20% of cells.
*Ki-67 - usu. high >20% of cells.
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Notes:
Notes:
*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>
==Gliosarcoma==
===General===
*Considered to be a variant of glioblastoma by WHO.<ref name=pmid19618114>{{cite journal |author=Han SJ, Yang I, Tihan T, Prados MD, Parsa AT |title=Primary gliosarcoma: key clinical and pathologic distinctions from glioblastoma with implications as a unique oncologic entity |journal=J. Neurooncol. |volume=96 |issue=3 |pages=313–20 |year=2010 |month=February |pmid=19618114 |pmc=2808523 |doi=10.1007/s11060-009-9973-6 |url=}}</ref>
*Rare ~ 200 cases reported in the literature.<ref name=pmid19618114/>
*Definition: gliosarcoma = glioblastoma + sarcomatous component.<ref name=pmid20415184>{{cite journal |author=Ayadi L, Charfi S, Khabir A, ''et al.'' |title=[Cerebral gliosarcoma: clinico-pathologic study of 8 cases] |language=French |journal=Tunis Med |volume=88 |issue=3 |pages=142–6 |year=2010 |month=March |pmid=20415184 |doi= |url=}}</ref>
*Usual location (like glioblastoma): temporal lobe.
===Microscopic===
Features:
*[[Glioblastoma]].
*Sarcomatous component (one of the following):<ref name=pmid19618114/><ref name=pmid20415184/>
**Fibroblastic.
**Cartilaginous.
**Osseous.
**Smooth muscle.
**Striated muscle.
**Adipocyte.
Image: [http://commons.wikimedia.org/wiki/File:Gliosarcoma_Histopathology_200x_EVG.jpg Gliosarcoma - elastic von Gieson (WC)].


==Pilocytic astrocytoma==
==Pilocytic astrocytoma==
Michael
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