Ice Cream and Imaging: Typical Appearance of Vestibular Schwannoma

Cranial nerve schwannomas most commonly arise from Schwann cells that myelinate the distal aspect of the vestibular division of the 8th cranial nerve. Vestibular schwannomas, sometimes referred to by the double misnomer "acoustic neuroma" (it is a double misnomer because they are not neuromas and they do not usually involve the acoustic division of cranial... 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 →

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 →

Brain Eating Amoeba

Naegleria fowleri, better known as "brain-eating amoeba", is a free-living amoeba that is a major cause of a rare brain infection called Primary Amebic Meningoencephalitis, which typically affects young people with a history of swimming in warm fresh water such as a lake or stream. After entering the nose and crawling up the olfactory nerves... Continue Reading →

Malignant Meningitis

The brain is surrounded by several layers of protective coverings collectively called meninges.  The semi-translucent innermost layers, called the leptomeninges, form a "shrink-wrap" around the brain that allows for easy flow of cerebrospinal fluid (CSF) along the outer surface of central nervous system structures. Unfortunately, it also allows for easy spread of neoplastic cells.  The image shows the inferior aspect... Continue Reading →

Myxopapillary Ependymoma: Radiology-Pathology Correlation

Myxopapillary ependymoma arises in the lumbar region of the spinal cord and typically produces symptoms associated with impingement of the spinal nerve roots of the cauda equina. It usually appears as an oval or sausage-shaped contrast-enhancing mass, like the one pictured in this MRI image (sagittal post-contrast T1 Fat-sat).  The myxopapillary ependymoma in the inset photograph represents a gross surgical... Continue Reading →

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 →

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