This video is part of a multi-part series reviewing new changes incorporated into the new 5th edition of the WHO classification of tumors of the central nervous system. This video utilizes a case-based format to review important changes in the classification of IDH-mutant and IDH-wildtype diffuse gliomas. https://youtu.be/cfPaeNb04Z8
IDH – Wildtype Astrocytoma: A case-based illustration of updates from the 5th Edition WHO Classification of CNS Tumors
This video is part of a multi-part series reviewing new changes incorporated into the new 5th edition of the WHO classification of tumors of the central nervous system. This video utilizes a case-based format to review important changes in the classification of IDH-mutant and IDH-wildtype diffuse gliomas. https://youtu.be/rskXkeY6DN0
Video: Board Prep – Familial Tumor Syndrome, Mystery Case #2
Mystery case review #2 is one of a series of videos designed to review the variety of brain tumors that arise in the context of a familial tumor syndromes. Test your knowledge with questions posed to the audience in a quiz like format. In-depth answers are provided for each quiz question. This series is perfect... Continue Reading →
Tripolar Atypical Mitosis in Glioblastoma
Cell division occurs in four major stages (prophase, metaphase, anaphase, and telophase) during which DNA duplicates itself and condenses, chromosomes centrally align and are pulled apart by two centrosomes on either side of the cell, and the cytoplasm separates to form two separate daughter cells. Cancer cells are able to enter into cell division by bypassing the usual complex ballet of cell... Continue Reading →
Classic Imaging: Cyst with an Enhancing Mural Nodule
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 →
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 →
Pilocytic Astrocytoma – Molecular testing to aid histologic diagnosis.
Pilocytic Astrocytoma (PA) characteristically exhibits biphasic morphology featuring densely fibrillar, compact regions alternating with loosely-cohesive microcystic or myxoid areas; the latter is pictured here. Diagnosis can be difficult, especially on small biopsies, but molecular testing can help. BRAF-KIAA1549 fusion occurs in about 70% of PAs, whereas BRAF V600E mutation occurs in about 5-10% of PAs.
Pilocytic Astrocytoma Cytology
Pilocytic astrocytoma is a circumscribed glioma (WHO Grade I) commonly found in children and young adults. Characteristic features include piloid cells with long, thin, hair-like cytoplasmic processes and a myxoid background, which are both seen here in this medium power image of a cytologic smear preparation performed during intraoperative consultation.
Reactive vs. Neoplastic Astrocytes
Astrocytes are star-shaped glial cells that comprise a large proportion of brain tissue. Non-neoplastic reactive astrocytes can sometimes be difficult to differentiate from the neoplastic astrocytes of glial tumors called astrocytomas. This GFAP stain highlights the key morphologic differences between the star-shaped and widely spread-out non-neoplastic reactive astrocytes compared to the neoplastic astrocytes in this glioblastoma, which exhibit crowding and severe variation in... Continue Reading →
Giant Cell Glioblastoma and Granular Mitoses
Giant Cell Glioblastoma, also called magnocellular or monstrocellular glioblastoma, is characterized by atypical cells that are extremely large, especially when compared to the non-neoplastic inflammatory cells seen on the left side of the image. The tumor has increased number of dividing cells, including typical mitotic figures (bottom left arrow) and atypical or granular mitoses (bottom... Continue Reading →