Mengioma: Vascular Changes and Prognosis

Meningiomas, like the one pictured here, typically show whorling architectural pattern and nuclear pseduoinclusions.  The vast majority of meningiomas are low grade (WHO Grade 1) dura-based tumors with good prognosis following complete resection.  However, recent studies have suggested that endothelial cell hypertrophy and/or microvascular proliferation in an otherwise typical meningioma are correlated with shorter progression free... 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.  

Atypical Meningioma – Mitoses and Macronucleoli

The vast majority of meningiomas are benign grade I tumors.  Meningiomas can be upgraded to grade II, called atypical meningiomas, if they show increased mitotic activity (4 or more mitoses in 10 high power fields) or other worrisome histopathologic features, such as tumor cells exhibiting a prominent and large nucleolus.  Notice the mitosis in the center-right of the image and... Continue Reading →

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 →

Epidermoid Cyst

Epidermoid cysts (pictured here with surrounding brain tissue) are histologically characterized by a thin layer of squamous epithelium similar to the epidermal lining the skin.  However, unlike skin (which sheds its outer layer of dead cells into the environment), the keratin debris of the sloughed-off upper layer of the epidermoid cyst build up within the cyst center resulting 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 →

Tuberculosis with Caseating Granuloma

Tuberculosis, or TB, is characterized by the formation of granulomas that often have central necrosis, called caseous necrosis due to its cottage-cheese appearance on gross evaluation.  Caseating granulomas characteristically have central necrosis surrounded by an immediate layer of macrophages and inflammatory cells, which, in turn, are surrounded by proliferating fibroblasts.  This effort to contain the... Continue Reading →

Video: Histopathological diagnosis of Peripheral Neuroblastic Tumors explained (i.e. Neuroblastoma, Ganglioneuroblastoma, and Ganglioneuroma), with an example review of Ganglioneuroma.

Histopathological diagnosis of Peripheral Neuroblastic Tumors explained (i.e. Neuroblastoma, Ganglioneuroblastoma, and Ganglioneuroma), with an example review of Ganglioneuroma. https://youtu.be/w9FEXK8tvJg

Multiple Sclerosis: Macrophages and Granular Mitosis in MS Plaques

Demyelinating lesions, such as those found in multiple sclerosis, typically contain numerous macrophages with abundant myelin debris filling the cytoplasm.  Additionally, atypical and granular mitoses can be seen in demyelinating lesions, though they can also occur in gliomas. Follow us on Facebook, Instagram, and YouTube:  Adventures in Neuropathology

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