Difference between revisions of "Neuropathology"

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Neuropathology (view source)

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*Pyknosis = nuclear shrinkage + darker staining.  
*Pyknosis = nuclear shrinkage + darker staining.  


Images:
=====Images=====
<gallery>
Image:Alzheimer_type_II_astrocyte_high_mag_cropped.jpg | Anoxic neurons (WC)
</gallery>
www:
*[http://www.neuropathologyweb.org/chapter2/images2/2-1HIE.jpg Anoxic neurons (neuropathologyweb.org)].
*[http://www.neuropathologyweb.org/chapter2/images2/2-1HIE.jpg Anoxic neurons (neuropathologyweb.org)].
*[http://commons.wikimedia.org/wiki/File:Alzheimer_type_II_astrocyte_high_mag_cropped.jpg Anoxic neurons (WC)].
*[http://moon.ouhsc.edu/kfung/iacp-olp/APAQ-Images/N1-MS-01-16.gif Anoxic neurons (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm] and [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm]. Accessed on: 31 October 2010.</ref>
*[http://moon.ouhsc.edu/kfung/iacp-olp/APAQ-Images/N1-MS-01-16.gif Anoxic neurons (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm] and [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm]. Accessed on: 31 October 2010.</ref>


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*Vitamin deficiency ([[pellagra]]).<ref name=pmid15577526>{{cite journal |author=Piercecchi-Marti MD, Pélissier-Alicot AL, Leonetti G, Tervé JP, Cianfarani F, Pellissier JF |title=Pellagra: a rare disease observed in a victim of mental and physical abuse |journal=Am J Forensic Med Pathol |volume=25 |issue=4 |pages=342–4 |year=2004 |month=December |pmid=15577526 |doi= |url=}}</ref>
*Vitamin deficiency ([[pellagra]]).<ref name=pmid15577526>{{cite journal |author=Piercecchi-Marti MD, Pélissier-Alicot AL, Leonetti G, Tervé JP, Cianfarani F, Pellissier JF |title=Pellagra: a rare disease observed in a victim of mental and physical abuse |journal=Am J Forensic Med Pathol |volume=25 |issue=4 |pages=342–4 |year=2004 |month=December |pmid=15577526 |doi= |url=}}</ref>


Images:
=====Images=====
*[http://commons.wikimedia.org/wiki/File:Central_chromatolysis_-_intermed_mag_-_cropped.jpg Central chromatolysis - intermed. mag. (WC)].
<gallery>
*[http://en.wikipedia.org/wiki/File:Central_chromatolysis_-_nf_-_very_high_mag.jpg Central chromatolysis - NF stain - very high mag. (WC)].
Image:Central_chromatolysis_-_intermed_mag_-_cropped.jpg | Central chromatolysis - intermed. mag. (WC)
 
Image:Central_chromatolysis_-_nf_-_very_high_mag.jpg | Central chromatolysis - NF stain - very high mag. (WC)
</gallery>
====Axonal swellings====
====Axonal swellings====
H&E:
H&E:
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**Classically described as "funnel-shaped" in benign astrocytes.<ref>MUN. 15 November 2010.</ref>
**Classically described as "funnel-shaped" in benign astrocytes.<ref>MUN. 15 November 2010.</ref>
*Peripheral nucleus.
*Peripheral nucleus.
*Image: [http://commons.wikimedia.org/wiki/File:Reactive_astrocytes_-_lfb_-_high_mag.jpg Reactive astrocytes - high mag. (WC)].
<gallery>
Image:Reactive_astrocytes_-_lfb_-_high_mag.jpg | Reactive astrocytes - high mag. (WC)
</gallery>


Alzheimer type II astrocyte:<ref>URL: [http://www.neuropathologyweb.org/chapter1/chapter1bAstrocytes.html http://www.neuropathologyweb.org/chapter1/chapter1bAstrocytes.html]. Accessed on: 2 July 2010.</ref>
Alzheimer type II astrocyte:<ref>URL: [http://www.neuropathologyweb.org/chapter1/chapter1bAstrocytes.html http://www.neuropathologyweb.org/chapter1/chapter1bAstrocytes.html]. Accessed on: 2 July 2010.</ref>
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*Indistinct cytoplasm.
*Indistinct cytoplasm.
*Found in the context of ''hepatic encephalopathy'' in basal ganglia and lower layers of cortex.<ref name=Ref_Klatt202>{{Ref Klatt|202}}</ref>
*Found in the context of ''hepatic encephalopathy'' in basal ganglia and lower layers of cortex.<ref name=Ref_Klatt202>{{Ref Klatt|202}}</ref>
*Images:  
*Images:
**[http://commons.wikimedia.org/wiki/File:Alzheimer_type_II_astrocyte_high_mag.jpg Alzheimer type II astrocytes (WC)].
**[http://neuroquiz.com/?page=image&topic=1&qid=2714 Alzheimer type II astrocytes (neuroquiz.com)].
**[http://neuroquiz.com/?page=image&topic=1&qid=2714 Alzheimer type II astrocytes (neuroquiz.com)].
**[http://www.neuropathologyweb.org/chapter10/images10/10-AlzIIl.jpg Alzheimer type II astrocytes (neuropathologyweb.org)] .
**[http://www.neuropathologyweb.org/chapter10/images10/10-AlzIIl.jpg Alzheimer type II astrocytes (neuropathologyweb.org)] .
<gallery>
Image:Alzheimer_type_II_astrocyte_high_mag.jpg| Alzheimer type II astrocytes. (WC)
</gallery>


Creutzfeldt cell:<ref name=Ref_PSNP18>{{Ref PSNP|18}}</ref>  
Creutzfeldt cell:<ref name=Ref_PSNP18>{{Ref PSNP|18}}</ref>  
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Bergmann gliosis (in the cerebellum):<ref name=Ref_PSNP18>{{Ref PSNP|18}}</ref>  
Bergmann gliosis (in the cerebellum):<ref name=Ref_PSNP18>{{Ref PSNP|18}}</ref>  
*Thin layer of cells (2-3 cells) with open nuclei that are larger than granular cell layer nuclei; seen with Purkinje cell loss.
*Thin layer of cells (2-3 cells) with open nuclei that are larger than granular cell layer nuclei; seen with Purkinje cell loss.
**Images:
 
***[http://commons.wikimedia.org/wiki/File:Bergmann_gliosis_-_intermed_mag.jpg Bergmann gliosis - intermed. mag. (WC)].
<gallery>
***[http://commons.wikimedia.org/wiki/File:Bergmann_gliosis_-_high_mag.jpg Bergmann gliosis - high mag. (WC)].
Image:Bergmann_gliosis_-_intermed_mag.jpg | Bergmann gliosis - intermed. mag. (WC)
***[http://commons.wikimedia.org/wiki/File:Metastatic_adenocarcinoma_-_cerebellum_-_intermed_mag.jpg Bergmann gliosis due to compression by metastasis - intermed mag. (WC)].
Image:Bergmann_gliosis_-_high_mag.jpg | Bergmann gliosis - high mag. (WC)
***[http://tpx.sagepub.com/content/35/5/676/F5.expansion.html Bergmann gliosis (sagepub.com)].
Image:Metastatic_adenocarcinoma_-_cerebellum_-_intermed_mag.jpg | Bergmann gliosis due to compression by metastasis - intermed mag. (WC)
</gallery>
Image:
*[http://tpx.sagepub.com/content/35/5/676/F5.expansion.html Bergmann gliosis (sagepub.com)].


====Reactive change vs. malignancy====
====Reactive change vs. malignancy====
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*Rosenthal fibres = worm-like or corkscrew-like (brightly) eosinophilic bodies; 10-40 micrometers.
*Rosenthal fibres = worm-like or corkscrew-like (brightly) eosinophilic bodies; 10-40 micrometers.
**Key feature: variable thickness; helps separate from RBCs.
**Key feature: variable thickness; helps separate from RBCs.
**Well-seen on trichrome stains.
**Well-seen on trichrome stains.  
**Images: [http://en.wikipedia.org/wiki/File:Rosenthal_HE_40x.jpg Rosenthal fibres (WP)], [http://commons.wikimedia.org/wiki/File:Rosenthal_fibers.jpg Rosenthal fibres - smear (WC/AFIP)].
<gallery>
Image:Rosenthal_HE_40x.jpg | Rosenthal fibres. (WP)
Image:Rosenthal_fibers.jpg | Rosenthal fibres - smear (WC/AFIP)
</gallery>
*Eosinophilic granular bodies = related to Rosenthal fibres; round cytoplasmic hyaline droplets in astrocytes.<ref>{{Ref MBNP|11}}</ref>
*Eosinophilic granular bodies = related to Rosenthal fibres; round cytoplasmic hyaline droplets in astrocytes.<ref>{{Ref MBNP|11}}</ref>
**Image: [http://commons.wikimedia.org/wiki/File:Pilocytic_Micro.jpg EGBs (WC/AFIP)].
**Image: [Image:Pilocytic_Micro.jpg EGBs (WC/AFIP)].
*Pseudopalisading - picket fence-like alignment of cells; long axis of cells perpendicular to interface with other structures/cells.
*Pseudopalisading - picket fence-like alignment of cells; long axis of cells perpendicular to interface with other structures/cells.
**Pseudopalisading of tumour cells (around necrotic regions) is seen in glioblastoma.  
**Pseudopalisading of tumour cells (around necrotic regions) is seen in [[glioblastoma]].  


Note:  
Note:  
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*Negri bodies.
*Negri bodies.
**Cytoplasmic inclusions; classically in Purkinje cells of the cerebellum, pyramidal cells of Ammon's horn.
**Cytoplasmic inclusions; classically in Purkinje cells of the cerebellum, pyramidal cells of Ammon's horn.
**[[Rabies]].
**[[Rabies]].  
**Image: [http://commons.wikimedia.org/wiki/File:Rabies_encephalitis_Negri_bodies_PHIL_3377_lores.jpg Negri bodies (WC/CDC)].
<gallery>
Image:Rabies_encephalitis_Negri_bodies_PHIL_3377_lores.jpg | Negri bodies. (WC/CDC)
</gallery>


*Lewy bodies.
*Lewy bodies.
**Eosinophilic cytoplasmic inclusion - composed mostly of alpha-synuclein.<ref name=pmid15235805>{{cite journal |author=Marui W, Iseki E, Kato M, Akatsu H, Kosaka K |title=Pathological entity of dementia with Lewy bodies and its differentiation from Alzheimer's disease |journal=Acta Neuropathol. |volume=108 |issue=2 |pages=121–8 |year=2004 |month=August |pmid=15235805 |doi=10.1007/s00401-004-0869-4 |url=}}</ref>
**Eosinophilic cytoplasmic inclusion - composed mostly of alpha-synuclein.<ref name=pmid15235805>{{cite journal |author=Marui W, Iseki E, Kato M, Akatsu H, Kosaka K |title=Pathological entity of dementia with Lewy bodies and its differentiation from Alzheimer's disease |journal=Acta Neuropathol. |volume=108 |issue=2 |pages=121–8 |year=2004 |month=August |pmid=15235805 |doi=10.1007/s00401-004-0869-4 |url=}}</ref>
**Image: [http://commons.wikimedia.org/wiki/File:Lewy_Koerperchen.JPG Lewy body (WC)].
<gallery>
 
Image:Lewy_Koerperchen.JPG | Lewy body. (WC)
</gallery>
====Table of inclusions====
====Table of inclusions====
{| class="wikitable sortable"  
{| class="wikitable sortable"  
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| [[Parkinson disease]], dementia with Lewy bodies
| [[Parkinson disease]], dementia with Lewy bodies
| morphology dependent on <br>location in brain; +ve for alpha-synuclein, <br>alpha-B crystallin, ubiquitin
| morphology dependent on <br>location in brain; +ve for alpha-synuclein, <br>alpha-B crystallin, ubiquitin
| [http://commons.wikimedia.org/wiki/File:Lewy_Koerperchen.JPG], [http://firstaidteam.com/usmlerximages/v/USMLERxLewy+bodies.gif.html]
| [Image:Lewy_Koerperchen.JPG], [http://firstaidteam.com/usmlerximages/v/USMLERxLewy+bodies.gif.html]
|-  
|-  
| Lafora body
| Lafora body
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| rabies
| rabies
| found in hippocampal neurons and Purkinje cells
| found in hippocampal neurons and Purkinje cells
| [http://commons.wikimedia.org/wiki/File:Rabies_encephalitis_Negri_bodies_PHIL_3377_lores.jpg]
| [Image:Rabies_encephalitis_Negri_bodies_PHIL_3377_lores.jpg]
|-  
|-  
| Hirano body
| Hirano body
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*+/-Cerebral edema.
*+/-Cerebral edema.


Image:
<gallery>
*[http://en.wikipedia.org/wiki/File:Streptococcus_pneumoniae_meningitis,_gross_pathology_33_lores.jpg Meningitis (WP)].
Image:Streptococcus_pneumoniae_meningitis,_gross_pathology_33_lores.jpg | Meningitis. (WC)
 
</gallery>
===Microscopic===
===Microscopic===
Features:
Features:
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*[[Lymphoma]].
*[[Lymphoma]].


Image:
<gallery>
*[http://commons.wikimedia.org/wiki/File:Meningitis_Histopathology.jpg Bacterial meningitis (WC)].
Image:Meningitis_Histopathology.jpg | Bacterial meningitis. (WC)
 
</gallery>
==Cerebral abscess==
==Cerebral abscess==
===General===
===General===
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*Pseudolaminar necrosis - (uncontrolled) cell death in the cerebral cortex in a band-like pattern,<ref>Hypoxic and Ischemic Encephalopathy. neuropathology.neoucom.edu. Accessed on: 29 December 2010.</ref> with a relative preservation of cells immediately adjacent to the meninges.
*Pseudolaminar necrosis - (uncontrolled) cell death in the cerebral cortex in a band-like pattern,<ref>Hypoxic and Ischemic Encephalopathy. neuropathology.neoucom.edu. Accessed on: 29 December 2010.</ref> with a relative preservation of cells immediately adjacent to the meninges.


Images:
Notes:
*Neurons of ''subiculum'' in adults - usu. normal (as they are resistant to ischemic changes).
====Images====
*Anoxic neurons:
*Anoxic neurons:
**[http://www.neuropathologyweb.org/chapter2/images2/2-1HIE.jpg Anoxic neurons (neuropathologyweb.org)].
**[http://www.neuropathologyweb.org/chapter2/images2/2-1HIE.jpg Anoxic neurons (neuropathologyweb.org)].
**[http://commons.wikimedia.org/wiki/File:Alzheimer_type_II_astrocyte_high_mag_cropped.jpg Anoxic neurons (WC)].
**[http://moon.ouhsc.edu/kfung/iacp-olp/APAQ-Images/N1-MS-01-16.gif Anoxic neurons (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm] and [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm]. Accessed on: 31 October 2010.</ref>
**[http://moon.ouhsc.edu/kfung/iacp-olp/APAQ-Images/N1-MS-01-16.gif Anoxic neurons (ouhsc.edu)].<ref>URL: [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/N1-MS-01-16-Ans.htm] and [http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm http://moon.ouhsc.edu/kfung/iacp-olp/apaq-text/n1-ms-01.htm]. Accessed on: 31 October 2010.</ref>
<gallery>
Image:Alzheimer_type_II_astrocyte_high_mag_cropped.jpg | Anoxic neurons. (WC)
</gallery>
*Hippocampal ischemic changes:
*Hippocampal ischemic changes:
**[http://www.neuropathologyweb.org/chapter2/images2/2-hippoHIE.jpg Hippocampus in HIE (neuropathologyweb.org)].<ref>URL: [http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html]. Accessed on: 14 January 2011.</ref>
**[http://www.neuropathologyweb.org/chapter2/images2/2-hippoHIE.jpg Hippocampus in HIE (neuropathologyweb.org)].<ref>URL: [http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html http://www.neuropathologyweb.org/chapter2/chapter2aHIE.html]. Accessed on: 14 January 2011.</ref>
*Pseudolaminar necrosis:
*Pseudolaminar necrosis:
**[http://commons.wikimedia.org/wiki/File:Cortical_pseudolaminar_necrosis_-_lfb_-_very_low_mag.jpg Pseudolaminar necrosis - very low mag. (WC)].
<gallery>
**[http://commons.wikimedia.org/wiki/File:Cortical_pseudolaminar_necrosis_-_lfb_-_intermed_mag.jpg Pseudolaminar necrosis - intermed. mag. (WC)].
Image:Cortical_pseudolaminar_necrosis_-_lfb_-_very_low_mag.jpg | Pseudolaminar necrosis - very low mag. (WC)
 
Image:Cortical_pseudolaminar_necrosis_-_lfb_-_intermed_mag.jpg | Pseudolaminar necrosis - intermed. mag. (WC)
Notes:
</gallery>
*Neurons of ''subiculum'' in adults - usu. normal (as they are resistant to ischemic changes).


==Multiple sclerosis==
==Multiple sclerosis==
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</ref>
</ref>


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Cerebral_amyloid_angiopathy_-_very_high_mag.jpg CAA - congo red - very high mag. (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Cerebral_amyloid_angiopathy_-_low_mag.jpg CAA - congo red - low mag. (WC)].
Image:Cerebral_amyloid_angiopathy_-_very_high_mag.jpg |CAA - congo red - very high mag. (WC)
*[http://commons.wikimedia.org/wiki/File:Cerebral_amyloid_angiopathy_-2b-_amyloid_beta_-_high_mag.jpg CAA - beta-amyloid - high mag. (WC)].
Image:Cerebral_amyloid_angiopathy_-_low_mag.jpg |CAA - congo red - low mag. (WC)
 
Image:Cerebral_amyloid_angiopathy_-2b-_amyloid_beta_-_high_mag.jpg |CAA - beta-amyloid - high mag. (WC)
</gallery>
===Stains===
===Stains===
*[[Congo red]].
*[[Congo red]].
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*Simple epithelium with ciliated cells and goblet cells.
*Simple epithelium with ciliated cells and goblet cells.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Colloid_Cyst_HE_40x.jpg Colloid cyst (WC)].
<gallery>
Image:Colloid_Cyst_HE_40x.jpg | Colloid cyst. (WC)
</gallery>
www:
*[http://www.ajnr.org/content/21/8/1470/F4.expansion.html Colloid cyst (ajnr.org)].<ref name=pmid11003281/>
*[http://www.ajnr.org/content/21/8/1470/F4.expansion.html Colloid cyst (ajnr.org)].<ref name=pmid11003281/>


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====IHC====  
====IHC====  
*Notch 3: smooth muscle and pericytes punctate +ve.<ref name=pmid12861102/>
*Notch 3: smooth muscle and pericytes punctate +ve.<ref name=pmid12861102/>
Image: [http://commons.wikimedia.org/wiki/File:CADASIL_-_very_high_mag.jpg Notch 3 staining in CADASIL (WC)].


Notes:
Notes:
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**Often diagnosed as ''Alzheimer's disease'' in the past.
**Often diagnosed as ''Alzheimer's disease'' in the past.


<gallery>
Image:CADASIL_-_very_high_mag.jpg | Notch 3 staining in CADASIL. (WC/Nephron)
</gallery>
====Skin biopsy diagnosis====
====Skin biopsy diagnosis====
*Can be diagnosed on a skin biopsy.<ref name=pmid11755616 >{{cite journal |author=Joutel A, Favrole P, Labauge P, ''et al.'' |title=Skin biopsy immunostaining with a Notch3 monoclonal antibody for CADASIL diagnosis |journal=Lancet |volume=358 |issue=9298 |pages=2049–51 |year=2001 |month=December |pmid=11755616 |doi=10.1016/S0140-6736(01)07142-2 |url=}}</ref>
*Can be diagnosed on a skin biopsy.<ref name=pmid11755616 >{{cite journal |author=Joutel A, Favrole P, Labauge P, ''et al.'' |title=Skin biopsy immunostaining with a Notch3 monoclonal antibody for CADASIL diagnosis |journal=Lancet |volume=358 |issue=9298 |pages=2049–51 |year=2001 |month=December |pmid=11755616 |doi=10.1016/S0140-6736(01)07142-2 |url=}}</ref>
Michael
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