Difference between revisions of "Neuropathology"

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Neuropathology (view source)

Revision as of 04:30, 4 November 2010

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major rearrangements
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*Resolving hematoma.
*Resolving hematoma.


==Immunohistochemistry==
{{Main|Immunohistochemistry}}
===General===
*S-100.
**Sensitive... but non-specific, e.g. also stains [[melanoma]].
===Glial===
*GFAP (glial fibrillary acidic protein) - should stain perikaryon.
===Neuronal===
*Synaptophysin.
*Chromogranin.
===Carcinoma vs. glial tumours===
*AE1/AE3 often +ve in glial tumours (e.g. astrocytomas, oligodendrogliomas); CAM5.2 is usu. -ve in glial tumours.<ref name=Ref_PSNP_12>{{Ref PSNP|12}}</ref>
===Others===
*APP (amyloid precursor protein) - detects axonal swellings.
*NF (neurofilament) - detects axonal swellings.
=Brain tumours=
{{main|Neuropathology tumours}}
Tumours are a big part of neuropathology.  The most common brain tumour is a metastasis.  The most common primary tumour is glioblastoma which has a horrible prognosis.
=Non-tumour=
==Alcohol & CNS==
==Alcohol & CNS==
===Clinical===
===Clinical===
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===Common non-specific findings===
===Common non-specific findings===
*[[Intracranial haemorrhage]] - due to trauma.
*[[Intracranial haemorrhage]] - due to trauma.
==Non-tumour==
==Acute disseminated encephalomyelitis==
===General===
*Thought to be autoimmune; often associated with/preceded by by viral illness.<ref name=pmid17438235>{{cite journal |author=Tenembaum S, Chitnis T, Ness J, Hahn JS |title=Acute disseminated encephalomyelitis |journal=Neurology |volume=68 |issue=16 Suppl 2 |pages=S23–36 |year=2007 |month=April |pmid=17438235 |doi=10.1212/01.wnl.0000259404.51352.7f |url=}}</ref>
*May mimic multiple sclerosis.
*Abbreviated "ADEM".
===Diagnosis===
*Need to r/o infection (with lumbar puncture).
*No old plaques on imaging (MRI).
===Microscopic===
Features:
*Spares subcortical fibres (???)
===Tx===
*Steroids.
*Plasmapheresis.
===DDx===
*Multiple sclerosis.
==Cysts==
===General===
*All are "benign", but some may be fatal due to spatial constraints.
===List of cysts===
*Colloid cyst.<ref>MUN. 11 Mar 2009.</ref>
**Columnar epithelium.
*Arachnoid cyst - considered precursor of meningioma.
**Psammoma bodies.
**Clumps of cells.
**Whorled pattern.
*Dermoid cyst.
**Skin + adnexal structures.
**... think of ovarian dermoid.
*Epidermoid.
*Choriod cyst.
**?
*Neuroenteric cyst.
*Epithelial cyst.


==Dementia==
==Dementia==
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Image: [http://moon.ouhsc.edu/kfung/jty1/NeuroTest/Q07-Ans.htm Huntington's disease (ouhsc.edu)].
Image: [http://moon.ouhsc.edu/kfung/jty1/NeuroTest/Q07-Ans.htm Huntington's disease (ouhsc.edu)].


==Brain tumours==
==Cysts==
{{main|Neuropathology tumours}}
===General===
Tumours are a big part of neuropathology.  The most common brain tumour is a metastasis.  The most common primary tumour is glioblastoma which has a horrible prognosis.
*All are "benign", but some may be fatal due to spatial constraints.


==Paediatric pathology==
===List of cysts===
===Joubert syndrome===
*Colloid cyst.<ref>MUN. 11 Mar 2009.</ref>
*Malformation of the cerebellar vermis.<ref name=ninds_joubert>[http://www.ninds.nih.gov/disorders/joubert/joubert.htm http://www.ninds.nih.gov/disorders/joubert/joubert.htm]</ref>
**Columnar epithelium.
*Arachnoid cyst - considered precursor of meningioma.
**Psammoma bodies.
**Clumps of cells.
**Whorled pattern.
*Dermoid cyst.
**Skin + adnexal structures.
**... think of ovarian dermoid.
*Epidermoid.
*Choriod cyst.
**?


===Epidemiology===
*Neuroenteric cyst.
*Autosomal recessive - mutation in a number of genes including NPHP1, AHI1, and CEP290.<ref name=ninds_joubert/>
*Epithelial cyst.


==Stroke==
==Stroke==
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*Late remyelinating.
*Late remyelinating.


==Weird stuff==
=Paediatric pathology=
===Joubert syndrome===
*Malformation of the cerebellar vermis.<ref name=ninds_joubert>[http://www.ninds.nih.gov/disorders/joubert/joubert.htm http://www.ninds.nih.gov/disorders/joubert/joubert.htm]</ref>
 
===Epidemiology===
*Autosomal recessive - mutation in a number of genes including NPHP1, AHI1, and CEP290.<ref name=ninds_joubert/>
 
=Weird stuff=
==Acute disseminated encephalomyelitis==
===General===
*Thought to be autoimmune; often associated with/preceded by by viral illness.<ref name=pmid17438235>{{cite journal |author=Tenembaum S, Chitnis T, Ness J, Hahn JS |title=Acute disseminated encephalomyelitis |journal=Neurology |volume=68 |issue=16 Suppl 2 |pages=S23–36 |year=2007 |month=April |pmid=17438235 |doi=10.1212/01.wnl.0000259404.51352.7f |url=}}</ref>
*May mimic multiple sclerosis.
*Abbreviated "ADEM".
 
===Diagnosis===
*Need to r/o infection (with lumbar puncture).
*No old plaques on imaging (MRI).
 
===Microscopic===
Features:
*Spares subcortical fibres (???)
 
===Tx===
*Steroids.
*Plasmapheresis.
 
===DDx===
*Multiple sclerosis.
 
==Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)==
==Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)==
===General===
===General===
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*[http://commons.wikimedia.org/wiki/File:VCJD_Tonsil.jpg vCJD - IHC (WC)].
*[http://commons.wikimedia.org/wiki/File:VCJD_Tonsil.jpg vCJD - IHC (WC)].


==Immunohistochemistry==
=See also=
{{Main|Immunohistochemistry}}
===General===
*S-100.
**Sensitive... but non-specific, e.g. also stains [[melanoma]].
 
===Glial===
*GFAP (glial fibrillary acidic protein) - should stain perikaryon.
 
===Neuronal===
*Synaptophysin.
*Chromogranin.
 
===Carcinoma vs. glial tumours===
*AE1/AE3 often +ve in glial tumours (e.g. astrocytomas, oligodendrogliomas); CAM5.2 is usu. -ve in glial tumours.<ref name=Ref_PSNP_12>{{Ref PSNP|12}}</ref>
 
===Others===
*APP (amyloid precursor protein) - detects axonal swellings.
*NF (neurofilament) - detects axonal swellings.
 
==See also==
*[[Brain tumours]].
*[[Brain tumours]].
*[[Pituitary gland]].
*[[Pituitary gland]].
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*[[Intracranial hematomas]].
*[[Intracranial hematomas]].


==References==
=References=
{{reflist|2}}
{{reflist|2}}


==External links==
=External links=
*[http://www.neuropathologyweb.org/ Neuropathology (neuropathologyweb.org)].
*[http://www.neuropathologyweb.org/ Neuropathology (neuropathologyweb.org)].
*[http://blog.lib.umn.edu/santa013/neuropathology/ Neuropathology cases (lib.umn.edu)].
*[http://blog.lib.umn.edu/santa013/neuropathology/ Neuropathology cases (lib.umn.edu)].
Michael
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