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→Pineoblastoma: +pictures +missing entities: PPID + PTPR
(→IHC) |
Jensflorian (talk | contribs) (→Pineoblastoma: +pictures +missing entities: PPID + PTPR) |
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Another ref.:<ref>URL: [http://www.springerlink.com/content/k4v88n6h6jknhp2t/fulltext.pdf http://www.springerlink.com/content/k4v88n6h6jknhp2t/fulltext.pdf]. Accessed on: 9 December 2010.</ref> | Another ref.:<ref>URL: [http://www.springerlink.com/content/k4v88n6h6jknhp2t/fulltext.pdf http://www.springerlink.com/content/k4v88n6h6jknhp2t/fulltext.pdf]. Accessed on: 9 December 2010.</ref> | ||
==Pineal parenchymal tumor of intermediate differentiation== | |||
===General=== | |||
*20% of all pineal tumors. | |||
*Affects all ages. | |||
*ICD-O: 9362/3 | |||
*No WHO grade yet, clinical behaviour corresponds to grade II/III<ref>{{Cite journal | last1 = Jouvet | first1 = A. | last2 = Saint-Pierre | first2 = G. | last3 = Fauchon | first3 = F. | last4 = Privat | first4 = K. | last5 = Bouffet | first5 = E. | last6 = Ruchoux | first6 = MM. | last7 = Chauveinc | first7 = L. | last8 = Fèvre-Montange | first8 = M. | title = Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. | journal = Brain Pathol | volume = 10 | issue = 1 | pages = 49-60 | month = Jan | year = 2000 | doi = | PMID = 10668895 }}</ref> | |||
===Microscopic=== | |||
Features:<ref>{{Cite journal | last1 = Fèvre-Montange | first1 = M. | last2 = Szathmari | first2 = A. | last3 = Champier | first3 = J. | last4 = Mokhtari | first4 = K. | last5 = Chrétien | first5 = F. | last6 = Coulon | first6 = A. | last7 = Figarella-Branger | first7 = D. | last8 = Polivka | first8 = M. | last9 = Varlet | first9 = P. | title = Pineocytoma and pineal parenchymal tumors of intermediate differentiation presenting cytologic pleomorphism: a multicenter study. | journal = Brain Pathol | volume = 18 | issue = 3 | pages = 354-9 | month = Jul | year = 2008 | doi = 10.1111/j.1750-3639.2008.00128.x | PMID = 18371183 }}</ref> | |||
*High cellularity. | |||
*Mild to moderate atypia. | |||
*Mitoses. | |||
*Usually no pinecytomatous rosettes. | |||
*High pleomorphism possible. | |||
Images: | |||
<gallery> | |||
File:Pinealis parechymal tumor.jpg | PPID, Smear (WC/jensflorian) | |||
</gallery> | |||
==Papillary Tumor of Pinealis region (PTPR)== | |||
===General=== | |||
*Very rare neuoepithelial tumor of adults. | |||
*Proposed ICD-O: 9395/3 | |||
*No WHO grade yet, clinical behaviour corresponds to grade II/III<ref>{{Cite journal | last1 = Fèvre-Montange | first1 = M. | last2 = Hasselblatt | first2 = M. | last3 = Figarella-Branger | first3 = D. | last4 = Chauveinc | first4 = L. | last5 = Champier | first5 = J. | last6 = Saint-Pierre | first6 = G. | last7 = Taillandier | first7 = L. | last8 = Coulon | first8 = A. | last9 = Paulus | first9 = W. | title = Prognosis and histopathologic features in papillary tumors of the pineal region: a retrospective multicenter study of 31 cases. | journal = J Neuropathol Exp Neurol | volume = 65 | issue = 10 | pages = 1004-11 | month = Oct | year = 2006 | doi = 10.1097/01.jnen.0000240462.80263.13 | PMID = 17021405 }}</ref> | |||
Gross: | |||
*Well circumscribed. | |||
*Can be quite large (2-4cm). | |||
*Macroscopy mimics pineocytoma. | |||
<gallery> | |||
File:PTPR MRI.jpg | PTPR MRI scan (WC/marvin101) | |||
</gallery> | |||
===Microscopic=== | |||
Features:<ref>{{Cite journal | last1 = Heim | first1 = S. | last2 = Beschorner | first2 = R. | last3 = Mittelbronn | first3 = M. | last4 = Keyvani | first4 = K. | last5 = Riemenschneider | first5 = MJ. | last6 = Vajtai | first6 = I. | last7 = Hartmann | first7 = C. | last8 = Acker | first8 = T. | last9 = Blümcke | first9 = I. | title = Increased mitotic and proliferative activity are associated with worse prognosis in papillary tumors of the pineal region. | journal = Am J Surg Pathol | volume = 38 | issue = 1 | pages = 106-10 | month = Jan | year = 2014 | doi = 10.1097/PAS.0b013e31829e492d | PMID = 24121176 }}</ref> | |||
*Papillary growth pattern. | |||
*Dense areas exhibit ependymal features. | |||
**Clear, vacuolated cytoplasm. | |||
**Rosettes. | |||
*Round to oval nuclei. | |||
*Mitoses (0-10/HPF). | |||
*Necroses. | |||
*Hyalinized vessels. | |||
===IHC=== | |||
* +ve for keratins (KL1, AE1/AE3, Cam5.2, CK18). | |||
* GFAP and Synaptophysin focally +ve. | |||
* S100+ve. | |||
* EMA mostly -ve. | |||
* NF and Kir 7.1-ve. | |||
DDx: | |||
[[Ependymoma]]. | |||
Images: | |||
<gallery> | |||
File:PTPR papillary tumor pinealis HE.jpg | PTPR H&E stain (WC/jensflorian) | |||
File:PTPR KL1.jpg | PTPR CK KL1 (WC/marvin101) | |||
File:PTPR papillary tumor pinealis CK18.jpg | PTPR CK18 IHC (WC/jensflorian) | |||
File:PTPR EMA.jpg | PTPR EMA IHC (WC/marvin101) | |||
File:PTPR Kir71.jpg | PTPR Kir 7.1 IHC (WC/marvin101) | |||
</gallery> | |||
==Pineoblastoma== | ==Pineoblastoma== | ||
| Line 67: | Line 132: | ||
*Males > females. | *Males > females. | ||
*Children & young adults. | *Children & young adults. | ||
*Corresponds to WHO IV (ICD-O: 9362/3) | |||
===Microscopic=== | ===Microscopic=== | ||
| Line 73: | Line 139: | ||
*Mitoses. | *Mitoses. | ||
*Nuclear atypia. | *Nuclear atypia. | ||
*Homer-wright & Flexner-Winterstein rosettes | |||
*Fleurettes. | |||
===IHC=== | |||
*GFAP -ve/+ve. | |||
*NF+ve. | |||
*Synaptophysin+ve | |||
*MIB-1: high. | |||
DDx: | DDx: | ||
*[[Glioblastoma]]. | *[[Glioblastoma]], small cell variant. | ||
*[[Small round cell tumors]]. | |||
Images: | Images: | ||
*[http://path.upmc.edu/cases/case212.html Pineoblastoma - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case212.html Pineoblastoma - several images (upmc.edu)]. | ||
<gallery> | |||
File:Pineoblastoma HE x200.jpg | Pineoblastoma H&E (WC/jensflorian) | |||
File:Pineoblastoma neurofilament.jpg | Neurofilament IHC in Pineoblastoma (WC/jensflorian) | |||
File:Pineoblastoma gfap.jpg | GFAP IHC in Pineoblastoma (WC/jensflorian) | |||
</gallery> | |||
==See also== | ==See also== | ||