True Ependymal Rosettes in Ependymoma

The microscopic appearance of ependymomas is dominated by the presence of radially-arranged tumor cells forming rosettes (black arrows), which are named for their resemblance to the flower-like architecture of rose windows in gothic cathedrals.  The perivascular pseudorosette, characterized by tumor cells radially arranged around a central vessel, is more common by far, but it is not specific to... 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 →

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 →

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

Glioblastomas

Glioblastomas are high grade astrocytomas that often exhibit microvascular proliferation, characterized by atypical hypertrophic and hyperplastic endothelial cells. A mitotic figure within a proliferating endothelial cell is present in the top right corner of the image.

Glioblastoma with Ring Enhancement (MRI)

This middle aged patient had a heterogeneous lesion with multiple irregular rings of enhancement following contrast administration. Biopsy revealed glioblastoma with microvascular proliferation and necrosis, both of which contain leaky blood vessels that contribute to contrast enhancement on imaging.

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