Secretory Meningioma: A unique Meningioma variant

The secretory subtype of meningioma (pictured here) is just one of many variants of meningioma, a usually histologically benign tumor that arises from the meninges (i.e. the outer coverings overlying the brain) and often contains concentrically-layered calcifications called psammoma bodies.  The secretory variant can be suspected on imaging by the exuberant edema often seen in the adjacent brain tissue.  Microscopically,... Continue Reading →

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 →

Severe Jaundice of the Brain

Not a trick of the eyes.  This brain with a pronounced green discoloration belonged to an adult with marked jaundice due to acute and severe liver disease. Jaundice occurs when the blood carries higher than normal levels of bilirubin, a substance that is usually processed by the liver into bile which is then eliminated via the stool and urine. Liver disease... Continue Reading →

Multiple Schwannomas in Neurofibromatosis Type II (NF2)

Schwannomas are typically sporadic lesions which stem from the Schwann cells that myelinate (or insulate) the peripheral nerves.  Patients with multiple schwannomas are more likely to have an associated familial tumor syndrome, such as Neurofibromatosis Type II (NF2). NF2 is a disorder in which a person inherits a defective gene, called NF2, that affects the merlin tumor suppressor protein thereby permiting... Continue Reading →

Stroke: Resolving Infarction

Brain infarction, or stroke, refers to brain tissue death due to a lack of life-sustaining blood flow to this area.  This brain, which belonged to a person with extensive cardiovascular disease, shows a resolving infarction involving the cerebral cortex of the occipital lobe.  Microscopically this yellow-brown discolored area is infiltrated by an army of macrophages that slowly removes the dead brain tissue until,... Continue Reading →

Glomus Jugulare Tumor

Glomus jugulare tumor is a slow-growing neoplasm that is often found incidentally. It arises within the jugular foramen of the temporal bone, near the opening of the foramen magnum (the large hole at the base of the skull where the spinal cord and brainstem connect).  The jugular foramen contains the cranial nerves IX, X, and XI and patients will often present with... Continue Reading →

Acute Traumatic Brain Injury – Hemorrhagic Infarction

Acute traumatic brain injury (TBI) can result in a variety of hemorrhagic cerebral insults leading to brain death.  This photograph depicting a brain of a person involved in a motor vehicle accident, shows a large hemorrhage in the left temporal-occipital region that 1. involves the brain tissue proper (i.e. intraparenchymal hemorrhage), 2. extends beneath the arachnoid layer of... Continue Reading →

Spinal Hematoma Associated with Lumbar Puncture

Patients with neurologic dysfunction often require a lumbar puncture (LP) for diagnostic or therapeutic purposes.  LP-associated complications are uncommon, but can include trauma to local tissues that may result in bleeding.  If vascular disruption occurs near or inside the thecal sac at the base of the spinal cord, then the resulting blood clot, or hematoma, can compress spinal nerve... Continue Reading →

Video: Intraoperative Consultation – Frozen Section

A high level walk-through of the process of a pathological evaluation of a specimen biopsied for an intraoperative consultation, including frozen section preparation. https://youtu.be/XU9zIjQ7Sjw   For further study on this topic and others related to neuropathology and neuroanatomy,  the following books come highly recommended, and a small portion of the proceeds (or any Amazon purchase through these links)... Continue Reading →

Video: Multiple Sclerosis Part II – Frozen Section Diagnosis

Part 2 of a multi-part series on Multiple Sclerosis that reviews the microscopic features and histopathologic diagnosis of a frozen section of brain tissue assessed during intraoperative consultation. https://youtu.be/60Qcjd3Ri38   For further study on this topic and others related to neuropathology and neuroanatomy,  the following books come highly recommended, and a small portion of the proceeds (or any... Continue Reading →

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