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 →

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Verocay Bodies in Schwannoma

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 →

Oligodendroglioma: the ‘Fried Egg’ Brain Tumor

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 →

Gemistocytic Astrocytoma

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 →

Brain Edema

Cerebral edema, or increased swelling in the brain, can occur as the result of numerous etiologies, such as infection, inflammation, metabolic derangement, or neoplastic processes.  Typically the brain has an undulating contour featuring crests or bumps called gyri, and troughs or grooves, called sulci.  The mass effect produced by cerebral edema results in pushing or... Continue Reading →

Dandy-Walker Malformation

Dandy-Walker malformation, an uncommon brain abnormality that may be seen in isolation or in association with other congenital abnormalities of brain development, is characterized by an enlarged posterior fossa, agenesis or hypoplasia of the cerebellar vermis, and cystic dilatation of the fourth ventricle.  In this case of a term infant with multiple congenital abnormalities, the superior most aspect of the... Continue Reading →

Lacunar Infarction of Basal Ganglia

A lacunar infarct is a small infarction, or stroke, that is usually less than about 1 to 1.5 cm in size and typically occurs in deep cerebral structures (e.g. basal ganglia) of hypertensive or diabetic patients with small vessel disease of deep penetrating arteries (e.g. lenticulostriate arteries) . The gross impression of this brain, which belonged to... Continue Reading →

Leptomeningitis and Perivascular Spread

Many blood vessels that supply the brain and spinal cord initially run within the covering layers on the external surface, called the leptomeninges (also known as the pia-arachnoid), before plunging into the deeper neural tissue. As the vessel transitions from the outer layers into deeper tissue, the perivascular space immediately surrounding the vessel, called Virchow-Robin space, may provide a conduit for infectious/inflammatory processes. ... Continue Reading →

Infection/Inflammation of Spine and Nerve Roots

The spinal cord is covered by protective outer connective tissue layers called the pia-arachnoid or leptomeninges.  Inflammatory or infectious processes that involve the leptomeninges, called leptomeningitis, can also involve the adjacent spinal nerve roots, which similarly have an outer covering of connective tissue that is continuous with the leptomeninges.  The image depicts a spinal cord with acute... Continue Reading →

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