Neuropath - Tumors and Cysts

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jollyvulcan
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164788
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Neuropath - Tumors and Cysts
Updated:
2012-08-04 07:33:04
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Neuropath Tumors Cysts
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Neuropath - Tumors and Cysts
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    • Medulloblastoma aka infratentorial PNET
    • Tumor common in children arising from the roof of the 4th ventricle
    • Densely packed, dark blue cells + Synaptophysin (marker neuronal diff.) and + Reticulin
    • Homer-Right Rosettes in ~40% (attempts at neuroblastic differentiation) lacking a vascular core
    • Early CSF metastesis and leptomeingeal mets
    • HomerWright Rosettes as seen in a Meduloblastoma
    • Attempts at neuroblastic differentiation lacking a vascular core
  1. Retinoblastoma
  2. True rosettes of Flexner-Wintersteiner
    • Gross Juvenile Pilocytic Astrocytoma
    • Unencapsulated but well-circumscribed,heterogenous in appearance with both cystic and nodular components
    • Propensity for the 4th ventricle in children
    • Juvenile Pilocytic Astrocytoma
    • Well-circumscribed, cystic lesion with a mural nodule in the CBLM or BS
    • Juvenile Pilocytic Astrocytoma
    • Characteristic bipolar cells with long, thin hair-like processes- Alternates between densely and loosely lacked regions and microcystic spaces
    • Rosenthal Fibers (thick, elongated, red cigar / corkscrew-shaped eosinophilic bodies, the product of long-standing glial tumors made by astrocytic processes)
  3. Low-grade astrocytoma
    • Lowgrade Astrocytoma
    • Mostly hemispheric (temporal and frontallocations), no contrast enhancement
    • Low-grade Astrocytoma
    • Infiltrative with ill-defined borders, Increased Cellularity, “bland nuclei”, no mitotic figures
  4. GBM
    • GBM
    • Increased Cellularity with mitotic profiles and angiogenesis
    • Psedopallisading array arranged around regions of central necrosis
    • May show glomeruloid hyperplasia
    • GBM
    • Deep GM / WM (Thal +BG) 
    • + Ring Enhancement
    • Pleomorphic Xanthoastrocytoma (PEXA)
    • Supratentorial (50% T), Contrast enhancing ring, cystic c/a mural nodule
    • Pleomorphic Xanthoastrocytoma
    • Large, foamy cells with eosinophilic cytoplasm,and  lipids,Nuclear pleomorphism with rare mitoses
    • Generally look worse histologically than one would expect
    • Often have EGBs
    • Subependymal Giant Cell Astrocytoma (SEGA) as seen in Tuberous Sclerosis
    • Most commonly at the IVF of Monro
    • Oligodendroglioma
    • Often involve cortex (Frontal > Temporal) with hemorrhage and Calcifications
    • “Fried Egg” appearance due to artificial clearing of cytoplasm
    • “Chicken Wire” → calcified blood vessels between cells
    • 70% will be associated with a 1p19q co-deletion
  5. CNS Lymphoma with typical perivascular leukocytic infiltrates
    • CNS Lymphoma
    • Normally in the Frontal lobes and Deep WM withIsointense T2 and ring enhancement; Often multifocal
    • Ependymoma
    • Tumor of the fourth ventricle eminating from the roof with apparent vascularization
    • Ependymoma
    • Small, dark, round-oval nuclei with a dense vascular background interrupted by acellular regions called Pseudorosettes (cells surrounding a normal blood vessel)
    • Choroid Plexus Papilloma
    • +Transthyretin
  6. Pituitary Adenoma
    • Craniopharyngioma
    • Tumor of the sellar / hypothalamic region with solid and cystic components.
    • Craniopharyngioma
    • Solid and cystic components
    • Islands of columnar cells in a collagen matrix
    • Nodules of plump Ketatin
    • Meningioma
    • 2nd most common (20%), ♀ 2x > ♂, 5th– 7th decade 90% asymp
    • Meningioma
    • 90% Supratentorial
    • Often Parasagital
    • + Enhancement
    • Dural Tag
    • Schwannoma
    • Benign, Increased in NF-2, F > M, Peak 4th – 5th , Decreased hearingVertigo, Tinitis
  7. Antoni A (spindles in compact fascicles) and Antoni B (spindles in myxomatous, microcystic array)

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