Talk:Neuropathology tumours

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Glioblastoma

Microscopic

Sections show an infiltrating tumour composed of randomly arranged cells of astroglial origin, as shown by their eosinophilic cytoplasm drawn into processes. There is marked nuclear pleomorphism, abundant mitotic activity, vigorous microvascular proliferation and extensive areas of necrosis with pseudopalisading of tumour.

Final diagnosis

BRAIN:
-GLIOBLASTOMA (WHO GRADE IV).

Meningioma

See: Talk:Meningioma.

Anaplastic astrocytoma

Microscopic

The microscopic section/sections shows white matter with tumour. The tumour cell nuclei are oblong and have a marked irregular profile and occasionally eosinophilic cytoplasm. Mitoses are rare/common. There is no necrosis and no microvascular proliferation. Immunohistochemistry shows GFAP staining of the perikaryon in cytologically malignant cells. Occasional/Many/All tumour cells stain for p53. The Ki-67 is positive in approximately X% of tumour cells.


Final diagnosis

ANAPLASTIC ASTROCYTOMA, WHO GRADE 3.

Oligodendroglioma

Microscopic

The microscopic section/sections shows regularly distributed cells with round nuclei that are surrounded by clear halos. No mitoses are present. Microvascular proliferation is not seen. The nuclear atypia is mild-to-moderate. There is no nuclear overlapping.

Final diagnosis

OLIGODENDROGLIOMA, WHO GRADE 2.

Hemangioblastoma

Microscopic

The sections show a partially cystic vascular tumour with histomorphological normal endothelial cells and vacuolated polygonal cells with hyperchromatic nuclei. There is no mitotic activity. The tumour has a poorly demarcated border. Cerebellum adjacent to the tumour demonstrates Purkinje cell loss and Bergmann gliosis.

The large polygonal cells have cytoplasmic staining with alpha-inhibin and neuron-specific enolase (NSE). The tumour does not stain for EMA.

Final diagnosis

BRAIN, CEREBELLUM, EXCISION:
- HEMANGIOBLASTOMA (WHO GRADE I).

Metastatic large cell carcinoma

Microscopic

Sections show an infiltrating tumour composed of cells arranged in glands. There is marked nuclear pleomorphism and abundant mitotic activity. The nuclei are eccentrically placed in the cell. No streaming of cells is present. The nucleoli are not prominent.

Final diagnosis

BRAIN, CEREBELLUM:
-METASTATIC LARGE CELL ADENOCARCINOMA.

Neuroma

Microscopic

The section shows a medium-sized nerve with adjacent small organized micro-fascicles in collagen, consistent with nerve regeneration following injury.

Diagnosis

NERVE, LEFT RADIAL:
- TRAUMATIC NEUROMA.

Chordoma

Microscopic description

The sections show a tumour composed of irregular anatoming cords of physaliferous cells resting on a myxoid background. Mitotic activity is not detected.

Immunostains demonstrate that the tumour cells intensely express cytoplasmic for low molecular weight keratin (LMWCK) and membranous epithelial membrane antigen (EMA). There is weak, focal cytoplasmic expression of S100.

Final diagnosis

CLIVUS:
- CHORDOMA.

Pilocytic astrocytoma

Microscopic description

The smear shows bipolar cells with thick hair-like processes. The sections show a cellular tumour with eosinophilic cytoplasm drawn into processes. Eosinophilic granular bodies and Rosenthal fibres are present, as demonstrated with trichrome staining.

There is no nuclear pleomorphism and no mitotic activity. There is no microvascular proliferation and no necrosis.

Final diagnosis

BRAIN:
- PILOCYTIC ASTROCYTOMA (WHO GRADE I).