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Difference between revisions of "Neuropathology"
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→Neuroradiology
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==Neuroradiology== | ==Neuroradiology== | ||
Key factors to consider in evaluation: | |||
*If | *1) location | ||
*2) number of lesions - single vs. multiple | |||
*3) cystic vs. solid lesion | |||
*4) enhancement | |||
==Lesion location== | |||
In neuroradiology and neuropathology, real estate is crucial. Lesion location can often narrow your differential. | |||
Cortical lesions (gray matter): | |||
* oligodendroglioma | |||
* DNET | |||
* ganglioglioma | |||
* pleomorphic xanthoastrocytoma | |||
* extraventricular ependymoma | |||
Cortical-subcortical junction: | |||
* metastases | |||
* abscesses (hematogenous spread) | |||
Subcortical lesions (white matter): | |||
* glioblastoma | |||
* diffuse gliomas | |||
* demyelinating plaques | |||
Deep gray matter lesions (e.g. basal ganglia); | |||
* gliomas | |||
* hypertensive hemorrhage | |||
Cerebellar lesions: | |||
* medulloblastoma | |||
* pilocytic astrocytoma | |||
* AT/RT | |||
Intraventricular lesions: | |||
* ependymoma | |||
* subependymoma | |||
* pilocytic astrocytoma | |||
* central neurocytoma | |||
* rosette forming glioneuronal tumour of the fourth ventricle | |||
Suprasellar (above the pituitary): | |||
* craniopharyngioma | |||
* germinoma | |||
* pilomyxoid astrocytoma | |||
==Number of lesions== | |||
If ''single'' lesion = think primary, neoplastic | |||
If ''multiple'' lesions = think metastatic, neoplastic or infectious | |||
'''NB: glioblastoma can be multifocal''' (and the foci can be quite far apart) | |||
==Cystic vs. solid lesions== | |||
Some tumours are classically cystic with a small solid component (so-called cyst with a mural nodule) -- e.g. pilocytic astrocytoma, ganglioglioma, hemangioblastoma | |||
==Enhancing vs. non-enhancing:== | |||
*In adults, enhancing generally = high grade. | |||
*In pediatrics, it often depends on the pattern. | |||
Two main patterns to be mindful of -- ring enhancing lesions, and cystic lesions with a mural nodule. | |||
===Ring enhancing lesions=== | ===Ring enhancing lesions=== | ||
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*Demyelination (e.g. [[multiple sclerosis]]). | *Demyelination (e.g. [[multiple sclerosis]]). | ||
*Resolving hematoma. | *Resolving hematoma. | ||
===Cyst with enhancing mural nodule=== | |||
*hemangioblastoma (#1 in adults) | |||
*pilocytic astrocytoma (#1 in peds) | |||
*pleomorphic xanthoastrocytoma | |||
*ganglioglioma | |||
==Grossing== | ==Grossing== | ||