Neurohistology

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This article covers basic (normal) neurohistology. It is essential to have a good grasp on neurohistology... before doing neuropathology.

Normal cells

  • Neuron:
    • Abundant cytoplasm - key feature.
    • Often very large cells, with angled edges.
    • Prominent nucleolus.
    • Nissl substance (granular perinuclear material - rough ER).
  • Glial cells.
    • Oligodendrocyte.
      • Small round nuclei (lymphocyte-like nucleus) - key feature.
      • May resemble a fried egg on H&E (clear cytoplasm, central nucleus).
    • Astrocyte.
    • Microglia - macrophage of the brain (derived from monocyte).
      • May be large.
      • May have vesicles.
      • Rarely seen in normal tissue.
  • Ependyma.

Normal cellular constituents in a table

Key feature Other features Image
Neuron cytoplasm Nissl substance (prominent
RER), "sharp" corners
in cell membrane, nucleolus
- usu. prominent[1] 		red neurons (WC)
Astrocyte non-ovoid nucleus no cytoplasm (unsw.edu)
Oligodendrocyte round small nucleus peri-nuclear clearing (vetmed.vt.edu)
Microglia rod-like shape,
may have "bent" nucleus 		rarely seen in normal tissue (ucsf.edu),(vcu.edu)

Neurons

There are many types of 'em. Broadly, they can be classified as:

  1. Pyramidal - have a pyramidal shape.
    1. Dentrites go to molecular layer.
    2. Axons go to outside of cortex.
  2. Non-pyramidal.

Motor neurons:

  • Coarse Nissl substance - key feature.
    • Nissl described as having a tigroid appearance.[2]
  • Polygonal shape.
  • Send dendrites in all directions.

Image: Motor neuron (stonybrookmedicalcenter.org).

Histology by anatomical structure

Subependyma

Features:[3]

  • Ependyma (simple ciliated cuboidal epithelium).
  • Subependymal plate - connective tissue with blood vessels.

Pons

Features:

Caudate

Features:

  • Neurons with adjacent ependymal lining.[5]
    • The caudate forms lateral wall of lateral ventricle.

Notes:

  • Caudate, putamen and nucleus accumbens are collectively called neostriatum.[6]

Putamen

Features:

  • Histologically identical to the caudate - but not adjacent to a ventricle, i.e. an ependymal lining.
  • Striatopallidal fibers AKA pencils of Wilson (also pencil fibers of Wilson[6]) - bundles of blue fibres (on H&E LFB).

Globus pallidus

Features:

  • Histologically distinct from caudate and putamen.

Hippocampus

Structures

Hippocampal formation:[8]

  1. Dentate gyrus.
  2. Hippocampus proper (AKA Ammon's horn) - this is subdivided:
    • Cornu ammonis 3 (CA3) - location: superior.
      • Large pyramidal neurons.
    • CA1 (AKA Sommer's sector) - location: inferior (next to subiculum).
      • Small dispersed pyramidal neurons.
    • CA2 - location: in between CA3 and CA1, lateral.
      • Narrow band of neurons between CA3 and CA1.
    • CA4 - location: medial (closest to dentate gyrus; CA4 sits in "open" part of "U").
  3. Subiculum (AKA subicular complex).
    • Transitions to the six layers in the entorhinal cortex.

Images:

Important notes:

  • CA1 - weak link, dies in ischemia, affected by hypoglycemia, degenerative diseases and toxins.
  • CA2 - resistant to ischemia.

Layers of CA[9]

  1. Molecular layer - opposed to the dentate gyrus (of Hippocampal formation).
  2. Neurons (described above).
  3. Alveus - opposed to the lateral ventricle.
    • Connects to the mammillary bodies via the fornix (circuit of Papez).

Cerebellum

Main components:

Dentate nucleus

Features:[10]

  • Ribbon of grey matter.
    • Large neurons.
    • Small neurons.

Cerebellar cortex

  • Layers (superficial to deep) - mnemonic MPG:[11]
    1. Molecular layer -- "very pink" on H&E.
      • Inhibitory interneurons: stellate cells, basket cells.
    2. Purkinje cell layer.
      • One cell layer thick - hueuege cells (~50-80 micrometers[1]).
        • Very large nucleus (~4x RBC diameter =~ 4x the size of granule cell).
          • Large nucleolus (~1x RBC diameter =~ size of granule cell).
    3. Granule cell layer -- "very blue" on H&E.
      • Granule cells (many), interneurons (Golgi cells --few in number). (???)
  • Images:

Notes:

  • Bergmann glia are found between the molecular layer & granular layer. They are normally not seen. They are increased & prominent in pathologic states (e.g. ischemia); "Bergmann gliosis".[12]

Cerebral cortex

Layers (superficial to deep):

  1. Molecular layer.
    • Empty appearing.
  2. Outer granular layer.
    • Higher cell density & smaller cells than pyramidal layer.
  3. Outer pyramidal layer.
  4. Inner granular layer.
    • Not prominent in frontal cortex.
    • Where the thalamic axons end.
    • Divided in three (a, b, c) in the calcarine cortex due to two white matter bands (external band of Baillarger, internal band of Baillarger) than are grossly identified as the line of Gennari.[13]
  5. Inner pyramidal layer.
    • Location of Betz neurons - large motor neurons of cerebral cortex.
  6. Multiforme layer (Polymorphic layer).

Images:

Pineal gland

Features:[15][16]

  • Cells in lobulated clusters or linear arrays (low power).
  • Pinealocyte:
    • Light staining and round nuclei with neuroendocrine look (i.e. salt-and-pepper chromatin).
    • Broad rim of light cytoplasm.
  • Astrocytes:
    • Cylindrical hyperchromatic nucleus ~ 1/2 the size of pinealocyte.

Images:

Notes:

  • Highly cellular structure - may be confused with (metastatic) small cell carcinoma.
  • Often calcified.

IHC

  • Synaptophysin +ve.[15]

See also

References

  1. ↑ 1.0 1.1 Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 16. ISBN 978-0443069826.
  2. ↑ URL: http://www.stonybrookmedicalcenter.org/pathology/neuropathology/chapter1. Accessed on: 5 July 2010.
  3. ↑ Croul SE. 28 June 2010.
  4. ↑ Croul SE. 28 June 2010.
  5. ↑ URL: http://www.stonybrookmedicalcenter.org/pathology/neuropathology/chapter1. Accessed on: 2 July 2010.
  6. ↑ 6.0 6.1 Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 23-34. ISBN 978-0443069826.
  7. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 23. ISBN 978-0443069826.
  8. ↑ URL: http://www.stonybrookmedicalcenter.org/pathology/neuropathology/chapter1. Accessed on: 2 July 2010.
  9. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 25. ISBN 978-0443069826.
  10. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 27. ISBN 978-0443069826.
  11. ↑ URL: http://www.stonybrookmedicalcenter.org/pathology/neuropathology/chapter1. Accessed on: 2 July 2010.
  12. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 18. ISBN 978-0443069826.
  13. ↑ Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 24. ISBN 978-0443069826.
  14. ↑ URL: http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-01-Ans.htm and http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm. Accessed on: 31 October 2010.
  15. ↑ 15.0 15.1 Perry, Arie; Brat, Daniel J. (2010). Practical Surgical Neuropathology: A Diagnostic Approach: A Volume in the Pattern Recognition series (1st ed.). Churchill Livingstone. pp. 25-26. ISBN 978-0443069826.
  16. ↑ 16.0 16.1 URL: http://www.lab.anhb.uwa.edu.au/mb140/corepages/endocrines/endocrin.htm. Accessed on: 31 October 2010.

External links

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