Difference between revisions of "Cortical tuber"

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[[Image:Tuber HE 20191014 011.jpg|thumb|right|[[Micrograph]] showing a cortical tuber. [[H&E stain]]. (WC/KGH)]]
[[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.


==Associations==
<gallery>
File:Tuber_GFAP_20191014_012.jpg|GFAP sparing dysmorphic ballon cells.
</gallery>


==Incidence==
==Imaging==
~1 in 10,000 population.<ref name=emed_ts>URL: [http://emedicine.medscape.com/article/1177711-overview http://emedicine.medscape.com/article/1177711-overview]. Accessed
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:Syndromes]]
[[Category:Malformation]]
[[Category:Neuropathology]]
[[Category:Neuropathology]]

Latest revision as of 13:17, 14 October 2019

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.


General

  • Cortical tubers are malformative, epilepsy-associated.[1]
  • 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.[2]
  • Normal cortical lamination is lost in the lesion.
  • TSC2 has larger and more numerous tubers.[3]

IHC

  • Ballon cells are Vim+ve, MAP2+ve, Nestin+ve, GFAP+/-ve, NeuN+/-ve.

Imaging

Examples on Radiopedia [[1]]

DDx

See also

Tuberous sclerosis

References

  1. Cotter, JA. (Apr 2019). "An update on the central nervous system manifestations of tuberous sclerosis complex.". Acta Neuropathol. doi:10.1007/s00401-019-02003-1. PMID 30976976.
  2. Mühlebner, A.; Iyer, AM.; van Scheppingen, J.; Anink, JJ.; Jansen, FE.; Veersema, TJ.; Braun, KP.; Spliet, WG. et al. (2016). "Specific pattern of maturation and differentiation in the formation of cortical tubers in tuberous sclerosis omplex (TSC): evidence from layer-specific marker expression.". J Neurodev Disord 8: 9. doi:10.1186/s11689-016-9142-0. PMID 27042238.
  3. Overwater, IE.; Swenker, R.; van der Ende, EL.; Hanemaayer, KB.; Hoogeveen-Westerveld, M.; van Eeghen, AM.; Lequin, MH.; van den Ouweland, AM. et al. (12 2016). "Genotype and brain pathology phenotype in children with tuberous sclerosis complex.". Eur J Hum Genet 24 (12): 1688-1695. doi:10.1038/ejhg.2016.85. PMID 27406250.