Case 113 - Revision history

Michael: /* Diagnosis */

2015-09-27T02:38:05Z

Diagnosis

← Older revision		Revision as of 02:38, 27 September 2015
Line 273:		Line 273:
	{{hidden\|Diagnosis\|<center>PILOMYXOID ASTROCYTOMA GRADE II WHO WITH KIAA1549(Exon15)-BRAF(Exon9) FUSION</center>		{{hidden\|Diagnosis\|<center>PILOMYXOID ASTROCYTOMA GRADE II WHO WITH KIAA1549(Exon15)-BRAF(Exon9) FUSION</center>
	<br>		<br>
	Comment: Pilomyxoid astrocytomas are a variant of [[pilocytic astrocytoma]] and share the same genetic abberations such as KIAA1549-BRAF fusions as seen in the current case. They usually lack the typical compact areas with rosenthal fibers seen in pilocytic astrocytomas. The tumors have been designated as WHO grade II tumours in the 2007 WHO classification, because of their tendency to recur more often. <ref>{{Cite journal \| last1 = Brat \| first1 = DJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Fuller \| first3 = GN. \| last4 = Tihan \| first4 = T. \| title = Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. \| journal = Brain Pathol \| volume = 17 \| issue = 3 \| pages = 319-24 \| month = Jul \| year = 2007 \| doi = 10.1111/j.1750-3639.2007.00082.x \| PMID = 17598825 }}</ref> A hypothalamic/chiasmatic location itself is a adverse prognostic factor. <ref>{{Cite journal \| last1 = Colin \| first1 = C. \| last2 = Padovani \| first2 = L. \| last3 = Chappé \| first3 = C. \| last4 = Mercurio \| first4 = S. \| last5 = Scavarda \| first5 = D. \| last6 = Loundou \| first6 = A. \| last7 = Frassineti \| first7 = F. \| last8 = André \| first8 = N. \| last9 = Bouvier \| first9 = C. \| title = Outcome analysis of childhood pilocytic astrocytomas: a retrospective study of 148 cases at a single institution. \| journal = Neuropathol Appl Neurobiol \| volume = 39 \| issue = 6 \| pages = 693-705 \| month = Oct \| year = 2013 \| doi = 10.1111/nan.12013 \| PMID = 23278243 }}</ref>		Comment: Pilomyxoid astrocytomas are a variant of [[pilocytic astrocytoma]] and share the same genetic abberations such as KIAA1549-BRAF fusions as seen in the current case. They usually lack the typical compact areas with rosenthal fibers seen in pilocytic astrocytomas. The tumors have been designated as WHO grade II tumours in the 2007 WHO classification, because of their tendency to recur more often.<ref name=pmid17598825>{{Cite journal \| last1 = Brat \| first1 = DJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Fuller \| first3 = GN. \| last4 = Tihan \| first4 = T. \| title = Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. \| journal = Brain Pathol \| volume = 17 \| issue = 3 \| pages = 319-24 \| month = Jul \| year = 2007 \| doi = 10.1111/j.1750-3639.2007.00082.x \| PMID = 17598825 }}</ref> A hypothalamic/chiasmatic location itself is a adverse prognostic factor.<ref name=pmid23278243>{{Cite journal \| last1 = Colin \| first1 = C. \| last2 = Padovani \| first2 = L. \| last3 = Chappé \| first3 = C. \| last4 = Mercurio \| first4 = S. \| last5 = Scavarda \| first5 = D. \| last6 = Loundou \| first6 = A. \| last7 = Frassineti \| first7 = F. \| last8 = André \| first8 = N. \| last9 = Bouvier \| first9 = C. \| title = Outcome analysis of childhood pilocytic astrocytomas: a retrospective study of 148 cases at a single institution. \| journal = Neuropathol Appl Neurobiol \| volume = 39 \| issue = 6 \| pages = 693-705 \| month = Oct \| year = 2013 \| doi = 10.1111/nan.12013 \| PMID = 23278243 }}</ref>


			===References===
	{{Reflist\|2}}		{{Reflist\|2}}

	}}		}}


	===Other cases===		===Other cases===

Jensflorian: dx refined

2015-09-25T10:21:28Z

dx refined

← Older revision		Revision as of 10:21, 25 September 2015
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	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>PILOMYXOID ASTROCYTOMA GRADE II WHO</center>
			{{hidden\|Diagnosis\|<center>PILOMYXOID ASTROCYTOMA GRADE II WHO WITH KIAA1549(Exon15)-BRAF(Exon9) FUSION</center>
	<br>		<br>
	Comment: Pilomyxoid astrocytomas are a variant of [[pilocytic astrocytoma]] and share the same genetic abberations such as KIAA1549~~(Exon15)~~-BRAF~~(Exon9)~~ fusions as seen in the current case. They usually lack the typical compact areas with rosenthal fibers seen in pilocytic astrocytomas. The tumors have been designated as WHO grade II tumours in the 2007 WHO classification, because of their tendency to recur more often. <ref>{{Cite journal \| last1 = Brat \| first1 = DJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Fuller \| first3 = GN. \| last4 = Tihan \| first4 = T. \| title = Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. \| journal = Brain Pathol \| volume = 17 \| issue = 3 \| pages = 319-24 \| month = Jul \| year = 2007 \| doi = 10.1111/j.1750-3639.2007.00082.x \| PMID = 17598825 }}</ref> A hypothalamic/chiasmatic location itself is a adverse prognostic factor. <ref>{{Cite journal \| last1 = Colin \| first1 = C. \| last2 = Padovani \| first2 = L. \| last3 = Chappé \| first3 = C. \| last4 = Mercurio \| first4 = S. \| last5 = Scavarda \| first5 = D. \| last6 = Loundou \| first6 = A. \| last7 = Frassineti \| first7 = F. \| last8 = André \| first8 = N. \| last9 = Bouvier \| first9 = C. \| title = Outcome analysis of childhood pilocytic astrocytomas: a retrospective study of 148 cases at a single institution. \| journal = Neuropathol Appl Neurobiol \| volume = 39 \| issue = 6 \| pages = 693-705 \| month = Oct \| year = 2013 \| doi = 10.1111/nan.12013 \| PMID = 23278243 }}</ref>		Comment: Pilomyxoid astrocytomas are a variant of [[pilocytic astrocytoma]] and share the same genetic abberations such as KIAA1549-BRAF fusions as seen in the current case. They usually lack the typical compact areas with rosenthal fibers seen in pilocytic astrocytomas. The tumors have been designated as WHO grade II tumours in the 2007 WHO classification, because of their tendency to recur more often. <ref>{{Cite journal \| last1 = Brat \| first1 = DJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Fuller \| first3 = GN. \| last4 = Tihan \| first4 = T. \| title = Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. \| journal = Brain Pathol \| volume = 17 \| issue = 3 \| pages = 319-24 \| month = Jul \| year = 2007 \| doi = 10.1111/j.1750-3639.2007.00082.x \| PMID = 17598825 }}</ref> A hypothalamic/chiasmatic location itself is a adverse prognostic factor. <ref>{{Cite journal \| last1 = Colin \| first1 = C. \| last2 = Padovani \| first2 = L. \| last3 = Chappé \| first3 = C. \| last4 = Mercurio \| first4 = S. \| last5 = Scavarda \| first5 = D. \| last6 = Loundou \| first6 = A. \| last7 = Frassineti \| first7 = F. \| last8 = André \| first8 = N. \| last9 = Bouvier \| first9 = C. \| title = Outcome analysis of childhood pilocytic astrocytomas: a retrospective study of 148 cases at a single institution. \| journal = Neuropathol Appl Neurobiol \| volume = 39 \| issue = 6 \| pages = 693-705 \| month = Oct \| year = 2013 \| doi = 10.1111/nan.12013 \| PMID = 23278243 }}</ref>

Jensflorian: cat

2015-09-25T10:14:45Z

cat

← Older revision		Revision as of 10:14, 25 September 2015
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	[[Category:Cases]]		[[Category:Cases]]
			[[Category:Cases in neuropathology]]
	~~<!-- SELECT A CATEGORY~~		[[Category:Cases in neuropathology - senior]]
	[[Category:Cases in ~~genitourinary pathology~~]]
	-->

	[[Category:Cases difficulty 4]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->		[[Category:Cases difficulty 4]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->

Jensflorian: case 113

2015-09-25T10:13:01Z

case 113

New page

===Provided clinical history===
14 year old child with cognitive disturbances and hydrocephalus.

===Site===
Left thalamus.

===Primary image===
[[Image:Pilomyxoid astrocytoma 02.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image:Pilomyxoid astrocytoma 03.jpg |500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image:Pilomyxoid astrocytoma 04.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Myxoid [[schwannoma]], [[Pilocytic astrocytoma]], [[Pilomyxoid astrocytoma]], [[DNT]], [[Ganglioglioma]] </center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>There is no further information available</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>The elongated cell processes have a glial appearance</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas= No need for additional PAS staining here
| alc1= [[Image:Pilomyxoid astrocytoma 01.jpg |500px|link=|center|]]
| alc25= [[Image:Pilomyxoid astrocytoma 01.jpg |500px|link=|center|]]
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3= '''NEGATIVE'''
| afp=
| alk1=
| amacr=
| ar=
| atrx= '''NO LOSS'''
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2= '''NEGATIVE'''
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45= '''NEGATIVE'''
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap= '''POSITIVE'''
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1= '''NEGATIVE'''
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67= '''2%'''
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf= '''NEGATIVE'''
| nkx3_1=
| nse=
| oct3_4=
| p16=
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto= '''NEGATIVE'''
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim= '''POSITIVE'''
| vip=
| vzv=
| wt1= '''PARTIALLY POSITIVE'''
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf = '''KIAA1549(Exon15)-BRAF(Exon9) TRANSCRIPT FOUND'''
| EBV_pcr =
| egrf =
| h3f3a = '''WILDTYPE'''
| hhv8_pcr =
| identity_test =
| idh1_2 = '''WILDTYPE'''
| jak2_v617f =
| kit =
| loh_1p19q = '''NO LOH 1p/19q'''
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>PILOMYXOID ASTROCYTOMA GRADE II WHO</center>
<br>
Comment: Pilomyxoid astrocytomas are a variant of [[pilocytic astrocytoma]] and share the same genetic abberations such as KIAA1549(Exon15)-BRAF(Exon9) fusions as seen in the current case. They usually lack the typical compact areas with rosenthal fibers seen in pilocytic astrocytomas. The tumors have been designated as WHO grade II tumours in the 2007 WHO classification, because of their tendency to recur more often. <ref>{{Cite journal | last1 = Brat | first1 = DJ. | last2 = Scheithauer | first2 = BW. | last3 = Fuller | first3 = GN. | last4 = Tihan | first4 = T. | title = Newly codified glial neoplasms of the 2007 WHO Classification of Tumours of the Central Nervous System: angiocentric glioma, pilomyxoid astrocytoma and pituicytoma. | journal = Brain Pathol | volume = 17 | issue = 3 | pages = 319-24 | month = Jul | year = 2007 | doi = 10.1111/j.1750-3639.2007.00082.x | PMID = 17598825 }}</ref> A hypothalamic/chiasmatic location itself is a adverse prognostic factor. <ref>{{Cite journal | last1 = Colin | first1 = C. | last2 = Padovani | first2 = L. | last3 = Chappé | first3 = C. | last4 = Mercurio | first4 = S. | last5 = Scavarda | first5 = D. | last6 = Loundou | first6 = A. | last7 = Frassineti | first7 = F. | last8 = André | first8 = N. | last9 = Bouvier | first9 = C. | title = Outcome analysis of childhood pilocytic astrocytomas: a retrospective study of 148 cases at a single institution. | journal = Neuropathol Appl Neurobiol | volume = 39 | issue = 6 | pages = 693-705 | month = Oct | year = 2013 | doi = 10.1111/nan.12013 | PMID = 23278243 }}</ref>

{{Reflist|2}}

}}

===Other cases===
{{Cases navigation}}

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