Difference between revisions of "Neuropathology tumours"

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==Brain tumours - overview==
==Brain tumours - overview==
===Adult===
===Alphabetical===
For overview see [[:Category:Neuropathology_tumours|here]]
 
===By age group===
====Adult====
Four most common types of brain tumours:<ref>[http://neurosurgery.mgh.harvard.edu/abta/primer.htm http://neurosurgery.mgh.harvard.edu/abta/primer.htm]</ref>
Four most common types of brain tumours:<ref>[http://neurosurgery.mgh.harvard.edu/abta/primer.htm http://neurosurgery.mgh.harvard.edu/abta/primer.htm]</ref>
# Metastatic brain tumours (barely edges out primary tumours)
# Metastatic brain tumours (barely edges out primary tumours)
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# [[Meningioma]].
# [[Meningioma]].


===Children===
====Children====
# Pilocytic astrocytoma.
# [[Pilocytic astrocytoma]].
# [[Medulloblastoma]].
# [[Medulloblastoma]].
# [[Ependymoma]].
# [[Ependymoma]].
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===Location (most common)===
===Location (most common)===
Certain tumours like to hang-out at certain places:<ref>URL: [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif] and [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html]. Accessed on: 2 November 2010.</ref>
Certain tumours like to hang-out at certain places:<ref>URL: [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/files/4ce563fb7e8e48fc9ed8b42e296a7747.gif] and [http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html http://www.msdlatinamerica.com/ebooks/DiagnosticNeuropathologySmears/sid117213.html]. Accessed on: 2 November 2010.</ref>
*Cerebrum:
====Cerebrum====
**Cortical based - [[oligodendroglioma]].
**Cortical based - [[oligodendroglioma]].
**Grey-white junction - metastases.
**Grey-white junction - metastases.
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**Periventricular - CNS lymphoma.
**Periventricular - CNS lymphoma.
**Cystic - [[ganglioglioma]], [[pilocytic astrocytoma]], [[pleomorphic xanthoastrocytoma]].
**Cystic - [[ganglioglioma]], [[pilocytic astrocytoma]], [[pleomorphic xanthoastrocytoma]].
*Cerebellum:
====Cerebellum====
**Midline/central - [[medulloblastoma]].
**Midline/central - [[medulloblastoma]].
**Cystic lesion - pilocytic astrocytoma (younger individual), [[hemangioblastoma]] (older individual).
**Cystic lesion - pilocytic astrocytoma (younger individual), [[hemangioblastoma]] (older individual).
**Solid lesion (older individual) - [[metastasis]].
**Solid lesion (older individual) - [[metastasis]].
*Spinal cord:
====Spinal cord====
**[[Ependymoma]], glioblastoma.
**[[Ependymoma]], glioblastoma.
**Filum terminale - [[myxopapillary ependymoma]], [[paraganglioma]].
**Filum terminale - [[myxopapillary ependymoma]], [[paraganglioma]].
====Filum terminale====
====Filum terminale====
*Filum terminale = bottom end of the spinal cord - has a limited differential.
*Filum terminale = bottom end of the spinal cord - has a limited differential.
DDx:<ref>JLK. 31 May 2010.</ref>
DDx:<ref>JLK. 31 May 2010.</ref>
*[[Meningioma]].
*[[Meningioma]].
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====Cerebellopontine angle====
====Cerebellopontine angle====
*Abbreviated ''CP angle''.
*Abbreviated ''CP angle''.
DDx:<ref>R. Kiehl. 8 November 2010.</ref>
DDx:<ref>R. Kiehl. 8 November 2010.</ref>
*[[Schwannoma]].
*[[Schwannoma]].
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*IDH1 and IDH2 mutations - better survival.<ref name=pmid20975057>{{cite journal |author=Houillier C, Wang X, Kaloshi G, ''et al.'' |title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas |journal=Neurology |volume=75 |issue=17 |pages=1560–6 |year=2010 |month=October |pmid=20975057 |doi=10.1212/WNL.0b013e3181f96282 |url=}}</ref>
*IDH1 and IDH2 mutations - better survival.<ref name=pmid20975057>{{cite journal |author=Houillier C, Wang X, Kaloshi G, ''et al.'' |title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas |journal=Neurology |volume=75 |issue=17 |pages=1560–6 |year=2010 |month=October |pmid=20975057 |doi=10.1212/WNL.0b013e3181f96282 |url=}}</ref>


==Pilocytic astrocytoma==
==Astrocytic tumours==
{{Main|Pilocytic astrocytoma}}
{{Main|Astrocytoma}}


==Pilomyxoid astrocytoma==
* Diffuse [[Astrocytoma]]
{{Main|Pilomyxoid astrocytoma}}
* [[Anaplastic astrocytoma]]
* [[Glioblastoma]]
* [[Gliomatosis cerebri]]
* [[Pilocytic astrocytoma]] (PA)
* [[Pilomyxoid astrocytoma]] (PMA)
* [[Pleomorphic xanthoastrocytoma]] (PXA)
* [[Subependymal giant cell astrocytoma]] (SEGA)


==Pleomorphic xanthoastrocytoma==
==Oligodendroglial tumours==
*Abbreviated ''PXA''.
* [[Oligodendroglioma]]
{{Main|Pleomorphic xanthoastrocytoma}}
* Anaplastic oligodendroglioma
* [[Oligoastrocytoma]]
* Anaplastic oligoastrocytoma


==Subependymal giant cell astrocytoma==
==Ependymal tumours==
*Abbreviated ''SEGA''.
* [[Subependymoma]]
{{Main|Subependymal giant cell astrocytoma}}
* [[Myxopapillary Ependymoma]]
* [[Ependymoma]]
* Anaplastic ependymoma


==Oligoastrocytoma==
==Choroid plexus tumours==
{{Main|Oligoastrocytoma}}
* [[Choroid plexus papilloma]]
* Atypical choroid plexus papilloma
* [[Choroid plexus carcinoma]]


==Oligodendroglioma==
==Other neuroepithelial tumours==
{{Main|Oligodendroglioma}}
* Astroblastoma
* Chordoid glioma of the third ventricle
* [[Angiocentric glioma]]


==Subependymoma==
===Astroblastoma===
{{Main|Subependymoma}}
*No WHO grade yet.
*Very rare superficial tumor of young age.
*Large, cystic. Pushing margin towards CNS.
*Vasocentric growth, plump cells with absence of fibrillary pattern.
*GFAP+ve, Synaptohysin-ve, focally EMA/panCK+ve. MIB-1: 1-18 %.


==Myxopapillary Ependymoma==
<gallery>
{{Main|Myxopapillary Ependymoma}}
File:Astroblastoma_HE_Specimen.jpg | HE. (WC/jensflorian)
 
File:Astroblastoma_HE_papillae.jpg | HE. (WC/jensflorian)
==Ependymoma==
File:Astroblastoma.jpg | Astroblastoma (AFIP)
{{Main|Ependymoma}}
</gallery>
 
==Choroid plexus papilloma==
*Grade I WHO or Grade II WHO (atypical CPP)
{{Main|Choroid plexus papilloma}}
 
==Choroid plexus carcinoma==
{{Main|Choroid plexus carcinoma}}
 
==Angiocentric glioma==
*Grade I WHO neuroepithelial tumour.
{{Main|Angiocentric glioma}}


==Chordoid glioma of the 3rd ventricle==
===Chordoid glioma of the third ventricle===
* WHO grade II.
* WHO grade II.
* Slowly growing, non-invasive.
* Slowly growing, non-invasive.
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* GFAP+ve,  MIB-1 1-3%.
* GFAP+ve,  MIB-1 1-3%.


==Gangliocytoma==
==Neuronal and mixed neuronal/glial tumours==
* Desmoplastic infantile astrocytoma / ganglioglioma (DIA/DIG)
* [[Dysembryoplastic neuroepithelial tumour]]
* [[Central Neurocytoma]] / Extraventricular [[neurocytoma]]
* Cerebellar liponeurocytoma
* Papillary glioneuronal tumour
* Rosette-forming glioneuronal tumour of the fourth ventricle
* Gangliocytoma / Ganglioglioma
* Dysplastic ganglioglioma of the cerebellum (Lhermitte-Duclos)
* [[Paraganglioma]]
 
===Gangliocytoma===
* Grade I WHO neuronal tumour.
* Grade I WHO neuronal tumour.
** ICD-O code: 9492/0
** ICD-O code: 9492/0
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* Non-neoplastic, reticulin-rich glial stroma.
* Non-neoplastic, reticulin-rich glial stroma.


==Ganglioglioma==
===Ganglioglioma===
:'''Not''' to be confused with ''[[ganglioneuroma]]''.
:'''Not''' to be confused with ''[[ganglioneuroma]]''.
===General===
====General====
*Grade I WHO mixed neuronal-glial tumour.
*Grade I WHO mixed neuronal-glial tumour.
*ICD-O code: 9505/1 (Anaplastic ganglioglioma: 9505/3)
*ICD-O code: 9505/1 (Anaplastic ganglioglioma: 9505/3)
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*Recognized as a cause of [[epilepsy]].<ref name=pmid12125968>{{Cite journal  | last1 = Im | first1 = SH. | last2 = Chung | first2 = CK. | last3 = Cho | first3 = BK. | last4 = Lee | first4 = SK. | title = Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome. | journal = J Neurooncol | volume = 57 | issue = 1 | pages = 59-66 | month = Mar | year = 2002 | doi =  | PMID = 12125968 }}</ref>
*Recognized as a cause of [[epilepsy]].<ref name=pmid12125968>{{Cite journal  | last1 = Im | first1 = SH. | last2 = Chung | first2 = CK. | last3 = Cho | first3 = BK. | last4 = Lee | first4 = SK. | title = Supratentorial ganglioglioma and epilepsy: postoperative seizure outcome. | journal = J Neurooncol | volume = 57 | issue = 1 | pages = 59-66 | month = Mar | year = 2002 | doi =  | PMID = 12125968 }}</ref>


===Microscopic===
====Microscopic====
Features:
Features:
*Dysplastic neurons.
*Dysplastic neurons.
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*Necrosis
*Necrosis


===IHC===
====IHC====
*Neurons:
*Neurons:
**[[MAP2]] +ve
**[[MAP2]] +ve
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**CD34+/-ve
**CD34+/-ve


===DDx:===
====DDx:====
*[[DNT]].
*[[DNT]].
*[[Oligodendroglioma]].
*[[Oligodendroglioma]].
*Trapped cortical neurons in diffuse astrocytoma.
*Trapped cortical neurons in diffuse astrocytoma.


===Images===
====Images====
<gallery>
<gallery>
File:Ganglioglioma lymphocytic cuffing PAS.jpg | Lymphocytic cuffing in ganglioglioma (WC/jensflorian)
File:Ganglioglioma lymphocytic cuffing PAS.jpg | Lymphocytic cuffing in ganglioglioma (WC/jensflorian)
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*[http://path.upmc.edu/cases/case282.html Ganglioglioma - case 2 (upmc.edu)].
*[http://path.upmc.edu/cases/case282.html Ganglioglioma - case 2 (upmc.edu)].


==Dysembryoplastic neuroepithelial tumour==
*Abbreviated ''DNT''.
{{Main|Dysembryoplastic neuroepithelial tumour}}


===Lhermitte-Duclos disease===
*Abbreviated ''LDD''.
*[[AKA]] ''dysplastic cerebellar gangliocytoma''.<ref name=pmid20060133>{{Cite journal  | last1 = Yağci-Küpeli | first1 = B. | last2 = Oguz | first2 = KK. | last3 = Bilen | first3 = MA. | last4 = Yalçin | first4 = B. | last5 = Akalan | first5 = N. | last6 = Büyükpamukçu | first6 = M. | title = An unusual cause of posterior fossa mass: Lhermitte-Duclos disease. | journal = J Neurol Sci | volume = 290 | issue = 1-2 | pages = 138-41 | month = Mar | year = 2010 | doi = 10.1016/j.jns.2009.12.010 | PMID = 20060133 }}</ref>
*[[AKA]] ''dysplastic gangliocytoma of the cerebellum''.
{{Main|Lhermitte-Duclos disease}}


==Atypical teratoid/rhabdoid tumour==
==Pineal tumours==
:See also: ''[[Extrarenal malignant rhabdoid tumour]]''.
{{Main|Pineal gland}}
*Commonly abbreviated ''AT/RT''.
*May be written ''atypical teratoid rhabdoid tumour'', i.e. without the forward slash, or ''atypical teratoid-rhabdoid tumour'' (AT-RT).
{{Main|Atypical teratoid/rhabdoid tumour}}


==Medulloblastoma==
* [[Pineocytoma]]
{{Main|Medulloblastoma}}
* [[Pineal parenchymal tumour of intermediate differentiation]]
*Tumour of cerebellum - key feature.
* [[Pineoblastoma]]
*Morphologically identical supratentorial tumours are called [[primitive neuroectodermal tumour]] (PNET).
* [[Papillary tumour of the pineal region]]


==Primitive neuroectodermal tumour==  
==Embryonal tumours==
{{Main|Primitive neuroectodermal tumour}}
* [[Atypical teratoid/rhabdoid tumour]] (AT/RT) or (AT-RT)
 
* [[Medulloblastoma]]
==Embryonal tumour with abundant neuropil and true rosettes==
* [[Primitive neuroectodermal tumour]] (PNET)
*Abbreviated ''ETANTR''.
* [[Embryonal tumour with abundant neuropil and true rosettes]] (ETANTR)
{{Main|Embryonal tumour with abundant neuropil and true rosettes}}
 
==Astroblastoma==
*No WHO grade yet.
*Very rare superficial tumor of young age.
*Large, cystic. Pushing margin towards CNS.
*Vasocentric growth, plump cells with absence of fibrillary pattern.
*GFAP+ve, Synaptohysin-ve, focally EMA/panCK+ve. MIB-1: 1-18 %.
 
<gallery>
File:Astroblastoma_HE_Specimen.jpg | HE. (WC/jensflorian)
File:Astroblastoma_HE_papillae.jpg | HE. (WC/jensflorian)
File:Astroblastoma.jpg | Astroblastoma (AFIP)
</gallery>
 
 
==Meningioma==
{{Main|Meningioma}}


==Peripheral nerve sheath tumours==
==Peripheral nerve sheath tumours==
{{Main|Peripheral nerve sheath tumours}}
{{Main|Peripheral nerve sheath tumours}}
A classification:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref>
A classification:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref>
*Benign:
'''Benign:'''
**[[Schwannoma]].
*[[Schwannoma]].
**[[Neurofibroma]].
*[[Neurofibroma]].
**[[Perineurioma]].
*[[Perineurioma]].
*Ganglioneuroma.
**[[Traumatic neuroma]].
**[[Traumatic neuroma]].
*Malignant:
'''Malignant:'''
**[[Malignant peripheral nerve sheath tumour]] (MPNST).
*[[Malignant peripheral nerve sheath tumour]] (MPNST).
 
==Schwannoma==
{{Main|Schwannoma}}
 
==Neurofibroma==
{{Main|Neurofibroma}}


==Ganglioneuroma==
===Ganglioneuroma===
:'''Not''' to be confused with ''[[ganglioglioma]]''.
:'''Not''' to be confused with ''[[ganglioglioma]]''.
*[[AKA]] ganglioma.<ref>URL: [http://medical-dictionary.thefreedictionary.com/ganglioma http://medical-dictionary.thefreedictionary.com/ganglioma]. Accessed on: 8 November 2010.</ref>
*[[AKA]] ganglioma.<ref>URL: [http://medical-dictionary.thefreedictionary.com/ganglioma http://medical-dictionary.thefreedictionary.com/ganglioma]. Accessed on: 8 November 2010.</ref>
{{Main|Ganglioneuroma}}
{{Main|Ganglioneuroma}}
==Meningioma==
{{Main|Meningioma}}


==Chordoma==
==Chordoma==
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*Bcl-6 +ve.
*Bcl-6 +ve.
*Bcl-1 -ve.
*Bcl-1 -ve.
==Neurocytoma==
{{Main|Neurocytoma}}
==Central neurocytoma==
*Abbreviated ''CNC''.
{{Main|Central neurocytoma}}




==Lhermitte-Duclos disease==
*Abbreviated ''LDD''.
*[[AKA]] ''dysplastic cerebellar gangliocytoma''.<ref name=pmid20060133>{{Cite journal  | last1 = Yağci-Küpeli | first1 = B. | last2 = Oguz | first2 = KK. | last3 = Bilen | first3 = MA. | last4 = Yalçin | first4 = B. | last5 = Akalan | first5 = N. | last6 = Büyükpamukçu | first6 = M. | title = An unusual cause of posterior fossa mass: Lhermitte-Duclos disease. | journal = J Neurol Sci | volume = 290 | issue = 1-2 | pages = 138-41 | month = Mar | year = 2010 | doi = 10.1016/j.jns.2009.12.010 | PMID = 20060133 }}</ref>
*[[AKA]] ''dysplastic gangliocytoma of the cerebellum''.
{{Main|Lhermitte-Duclos disease}}


==Ganglioneuroblastoma==
==Ganglioneuroblastoma==
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