A forum dedicated to the expansion in neuropathology knowledge for students and practitioners alike.
The most common tumors found in the central nervous system and dura (i.e. the dense fibrous covering that envelops the brain) are those that have traveled from other body sites in a process called metastasis. Depicted here is hepatocellular carcinoma (HCC), a cancer of liver cells, that has metastasized to the dura overlying the anterior pole of the right frontal lobe. Microscopically, the neoplastic liver... Continue Reading →
Neurodegenerative diseases commonly have abnormal protein inclusions that ultimately contribute to neuron death. One such example is abnormally hyperphosphorylated tau protein, the major component of neurofibrillary tangles (NFTs), which are a key microscopic feature of Alzheimer Disease and lesser known neurodegenerative diseases, such as Frontotemporal Lobar Degeneration (FTLD). Like water in a vase, an NFT will assume the shape of the cell in which it arises. For example, the classic... Continue Reading →
A normal adult loses about 0.2% of brain volume every year after middle age. Compared to young and middle-aged adults, the brains of the elderly have comparatively widened sulci, narrowed gyri, a thin cortical ribbon, and enlarged ventricles due to progressive brain volume loss, which, clinically, may contribute slower processing speed for cognitive tasks and other changes. Microglia-mediated synaptic pruning and other etiologies for decreasing cortical volume in the... Continue Reading →
This case presents just one of many reasons why prenatal care is so important for prevention, detection, and treatment of devastating intrauterine infections. This video includes review of the microscopic appearance of the Herpes-infected brain and macroscopic findings of affected visceral organs. https://youtu.be/L7eHnEB9iDM
Cranial nerve schwannomas most commonly arise from Schwann cells that myelinate the distal aspect of the vestibular division of the 8th cranial nerve. Vestibular schwannomas, sometimes referred to by the double misnomer "acoustic neuroma" (it is a double misnomer because they are not neuromas and they do not usually involve the acoustic division of cranial... Continue Reading →
For many years the only mechanism for observing gross pathologic features of CNS neoplasms was to examine brains extracted after death. However, advancements in imaging technology now allow providers to observe typical gross neuropathological findings in the brains of living patients. Some brain tumors have characteristic MRI findings, an example of which is a cyst... Continue Reading →
Schwannomas are peripheral nerve sheath tumors that arise from cells that myelinate peripheral nerve axons called Schwann cells. A classic histologic finding in schwannomas are Verocay bodies (arrows), which consist of short palisades of tumor cell nuclei separated by eosinophilic anucleate bands of tumor cell processes. Verocay bodies are often more prominent in schwannomas that arise in the setting of a... Continue Reading →
Oligodendrogliomas often show the classic “fried egg” appearance, in which each cell contains a small round monomorphic nucleus with a perinuclear region of clearing, as well as small delicate blood vessels, or “chicken-wire vasculature”. The fried egg morphology is an artifact of formalin fixation and will not be observed in frozen tissue sections. In addition,... Continue Reading →
Astrocytomas (i.e. glial tumors that diffusely infiltrate through brain tissue) are composed of neoplastic astrocytes that may occasionally exhibit certain morphologic differences when observed microscopically. Gemistocytic astrocytes are characterized by eccentric nuclei and plump pink cytoplasm that superficially resembles the belly of a pregnant woman when viewed from above. Neoplasms that are predominantly composed of... Continue Reading →
