Jensflorian: /* Classification/grading */ INRGSS

2019-03-07T09:40:57Z

Classification/grading: INRGSS

← Older revision		Revision as of 09:40, 7 March 2019
Line 96:		Line 96:
	*Mitoses/karyorrhectic cells.		*Mitoses/karyorrhectic cells.
	*Molecular abnormalities.		*Molecular abnormalities.

			International Neuroblastoma Risk Group Staging System (INRGSS)
			* L1: Locoregional tumor without Image-Definging Risk factors (IDRFs)
			* L2: Locoregional tumor with one or more IDRFs
			* M: Distant metastatic disease (except Ms)
			* Ms: INRG Stage L1 or L2 tumor with metastatic disease confined to skin and/or liver and/or bone marrow and age below 18 months.

	==IHC==		==IHC==

Jensflorian: /* General */ update

2019-03-07T09:30:54Z

General: update

← Older revision		Revision as of 09:30, 7 March 2019
Line 9:		Line 9:
	Laboratory findings:		Laboratory findings:
	*Increased urine homovanillic acid.		*Increased urine homovanillic acid.

			Imaging:
			*mIBG uptake (>90% neuroblastomas)


	Predictors of a poor prognosis:<ref name=Ref_PCPBoD8_254>{{Ref PCPBoD8\|254}}</ref>		Predictors of a poor prognosis:<ref name=Ref_PCPBoD8_254>{{Ref PCPBoD8\|254}}</ref>
Line 16:		Line 20:
	*Near ploidy.		*Near ploidy.
	*N-MYC amplification.		*N-MYC amplification.
			*1p deletion /imbalance
	*Lymph node spread.		*Lymph node spread.
	*Distant spread.		*Distant spread.

Michael: /* IHC */

2015-11-16T03:47:23Z

IHC

← Older revision		Revision as of 03:47, 16 November 2015
Line 92:		Line 92:
	*Molecular abnormalities.		*Molecular abnormalities.

	===IHC===		==IHC==
	*PGP 9.5 +ve.<ref>{{Cite journal \| last1 = Ootsuka \| first1 = S. \| last2 = Asami \| first2 = S. \| last3 = Sasaki \| first3 = T. \| last4 = Yoshida \| first4 = Y. \| last5 = Nemoto \| first5 = N. \| last6 = Shichino \| first6 = H. \| last7 = Chin \| first7 = M. \| last8 = Mugishima \| first8 = H. \| last9 = Suzuki \| first9 = T. \| title = Useful markers for detecting minimal residual disease in cases of neuroblastoma. \| journal = Biol Pharm Bull \| volume = 31 \| issue = 6 \| pages = 1071-4 \| month = Jun \| year = 2008 \| doi = \| PMID = 18520032 }}</ref>		*PGP 9.5 +ve.<ref>{{Cite journal \| last1 = Ootsuka \| first1 = S. \| last2 = Asami \| first2 = S. \| last3 = Sasaki \| first3 = T. \| last4 = Yoshida \| first4 = Y. \| last5 = Nemoto \| first5 = N. \| last6 = Shichino \| first6 = H. \| last7 = Chin \| first7 = M. \| last8 = Mugishima \| first8 = H. \| last9 = Suzuki \| first9 = T. \| title = Useful markers for detecting minimal residual disease in cases of neuroblastoma. \| journal = Biol Pharm Bull \| volume = 31 \| issue = 6 \| pages = 1071-4 \| month = Jun \| year = 2008 \| doi = \| PMID = 18520032 }}</ref>
	**PGP = protein gene product.		**PGP = protein gene product.

Michael: split out

2015-11-16T03:47:09Z

split out

← Older revision		Revision as of 03:47, 16 November 2015
Line 1:		Line 1:
	~~#redirect~~ [[Adrenal gland~~#Neuroblastoma~~]]		'''Neuroblastoma''' is a [[malignant]] tumour of the [[adrenal gland]].

			''[[Olfactory neuroblastoma]]'' is dealt with separately.

			==General==
			Epidemiology:
			*Usually paediatric population.

			Laboratory findings:
			*Increased urine homovanillic acid.

			Predictors of a poor prognosis:<ref name=Ref_PCPBoD8_254>{{Ref PCPBoD8\|254}}</ref>
			*High mitotic-karyorrhectic index.
			*Lack of schwannian stroma.
			*>18 months.
			*Near ploidy.
			*N-MYC amplification.
			*Lymph node spread.
			*Distant spread.

			Classification:
			*In a grouping known as ''neuroblastic tumours'' which includes:<ref name=pmid10421272>{{cite journal \|author=Shimada H, Ambros IM, Dehner LP, Hata J, Joshi VV, Roald B \|title=Terminology and morphologic criteria of neuroblastic tumors: recommendations by the International Neuroblastoma Pathology Committee \|journal=Cancer \|volume=86 \|issue=2 \|pages=349–63 \|year=1999 \|month=July \|pmid=10421272 \|doi= \|url=}}</ref>
			**[[Ganglioneuroma]] (benign).
			**[[Ganglioneuroblastoma]] (intermediate).
			**Neuroblastoma (aggressive).

			==Gross==
			*Typically an abdominal mass.
			**~40% arise in the [[adrenal gland]].<ref name=Ref_PCPBoD8_253>{{Ref PCPBoD8\|253}}</ref>

			==Microscopic==
			Features:<ref name=pmid18635637>{{cite journal \|author=Chung EM, Murphey MD, Specht CS, Cube R, Smirniotopoulos JG \|title=From the Archives of the AFIP. Pediatric orbit tumors and tumorlike lesions: osseous lesions of the orbit \|journal=Radiographics \|volume=28 \|issue=4 \|pages=1193–214 \|year=2008 \|pmid=18635637 \|doi=10.1148/rg.284085013 \|url=}}</ref>
			*[[small round cell tumour\|Small round blue cell]]s separated by thin (pink) fibrous septa.
			*Homer-Wright rosettes.
			**Rosette with a small (~100 micrometers - diameter) meshwork of fibers (neuropil) at the centre.<ref name=pmid16551982>{{cite journal \|author=Wippold FJ, Perry A \|title=Neuropathology for the neuroradiologist: rosettes and pseudorosettes \|journal=AJNR Am J Neuroradiol \|volume=27 \|issue=3 \|pages=488–92 \|year=2006 \|month=March \|pmid=16551982 \|doi= \|url=}}</ref>
			*Neuropil-like stroma = paucicellular stroma with a cotton candy-like appearance; see comparison below.
			**>50% neuropil-like stroma -- otherwise it's a [[ganglioneurona]] or ganglioblastoma.

			Notes:
			*The fibrous septa are especially useful for differentiation from lymphoma.

			DDx:
			*[[Small round cell tumours]].
			**[[Wilms tumour]].
			**Lymphoma.
			**[[Hepatoblastoma]].

			===Images===
			<gallery>
			Image:Adrenal Neuroblastoma MP CTR.jpg\|Neuroblastoma - medium power]]
			Image:Adrenal Neuroblastoma 2 MP CTR.jpg\|Neuroblastoma - medium power (SKB)
			Image:Adrenal Neuroblastoma M2P PA.JPG\|Neuroblastoma - medium power]]
			Image:Adrenal Neuroblastoma VascularInvasion MP CTR.jpg\|thumb\|Neuroblastoma - vascular invasion - medium power]]
			Image:Adrenal Neuroblastoma MP3 PA.JPG\|Neuroblastoma - medium power]]
			Image:Adrenal Neuroblastoma MP PA.JPG\|Neuroblastoma - medium power]]
			Image:Adrenal Neuroblastoma 2 HP CTR.jpg\|Neuroblastoma - high power (SKB)
			Image:Adrenal Neuroblastoma 3 HP CTR.jpg\|Neuroblastoma - high power - blue cells arrayed around a core of fluffy pink neuropil (SKB)
			Image:Adrenal Neuroblastoma HP2 CTR.jpg\|Neuroblastoma - high power]]
			Image:Adrenal Neuroblastoma HP CTR.jpg\|Neuroblastoma - high power]]
			</gallery>
			*[http://radiographics.rsna.org/content/28/4/1193/F42.expansion Neuroblastoma (radiographics.rsna.org)].<ref>URL: [http://radiographics.rsna.org/content/28/4/1193.full http://radiographics.rsna.org/content/28/4/1193.full]. Accessed on: 12 January 2011.</ref>
			*[http://commons.wikimedia.org/wiki/File:Neuroblastoma_rosettes.jpg Neuroblastoma (WC)].
			*[http://farm3.static.flickr.com/2259/2274260465_afbea05f9b.jpg Neuroblastoma (flickr.com)].

			===Schwannian vs. neuropil===
			{\| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
			\| Feature
			\| Schwannian
			\| Neuropil
			\|-
			\| Cellularity
			\| high ~ spacing of cells < 30 µm
			\| low ~ spacing of cells > 100 µm
			\|-
			\| Fibrillary
			\| yes, long fine strands
			\| no
			\|-
			\| Associations
			\| ganglion cells
			\| neuroblasts
			\|-
			\| Cytoplasmic vacuolation
			\| yes
			\| ?
			\|-
			\|}

			===Classification/grading===
			Commonly grouped by the ''Shimada classification'', which depends on the presence a number of things including:
			*Mitoses/karyorrhectic cells.
			*Molecular abnormalities.

			===IHC===
			*PGP 9.5 +ve.<ref>{{Cite journal \| last1 = Ootsuka \| first1 = S. \| last2 = Asami \| first2 = S. \| last3 = Sasaki \| first3 = T. \| last4 = Yoshida \| first4 = Y. \| last5 = Nemoto \| first5 = N. \| last6 = Shichino \| first6 = H. \| last7 = Chin \| first7 = M. \| last8 = Mugishima \| first8 = H. \| last9 = Suzuki \| first9 = T. \| title = Useful markers for detecting minimal residual disease in cases of neuroblastoma. \| journal = Biol Pharm Bull \| volume = 31 \| issue = 6 \| pages = 1071-4 \| month = Jun \| year = 2008 \| doi = \| PMID = 18520032 }}</ref>
			**PGP = protein gene product.
			*NB-84 +ve.<ref name=pmid9500774>{{Cite journal \| last1 = Miettinen \| first1 = M. \| last2 = Chatten \| first2 = J. \| last3 = Paetau \| first3 = A. \| last4 = Stevenson \| first4 = A. \| title = Monoclonal antibody NB84 in the differential diagnosis of neuroblastoma and other small round cell tumors. \| journal = Am J Surg Pathol \| volume = 22 \| issue = 3 \| pages = 327-32 \| month = Mar \| year = 1998 \| doi = \| PMID = 9500774 }}</ref>
			**More sensitive that synaptophysin.
			*Synaptophysin +ve.
			*CD99 -ve.

			==EM==
			Distinctive EM appearance:<ref name=pmid1196755>{{Cite journal \| last1 = Mackay \| first1 = B. \| last2 = Masse \| first2 = SR. \| last3 = King \| first3 = OY. \| last4 = Butler \| first4 = J. \| title = Diagnosis of neuroblastoma by electron microscopy of bone marrow aspirates. \| journal = Pediatrics \| volume = 56 \| issue = 6 \| pages = 1045-9 \| month = Dec \| year = 1975 \| doi = \| PMID = 1196755 }}</ref>
			*Dendritic processes with longitudinally oriented microtubules.
			*Membrane bound electron-dense granules (contain catecholamines).
			*Desmosomes
			**Not seen in [[EWS]], [[RMS]], lymphomas.
			*Membrane densities.

			Pertinent negative:<ref name=pmid1196755/>
			*No glycogen.
			**Seen in [[EWS]].

			==See also==
			*[[Adrenal gland]].

			==References==
			{{Reflist\|1}}

	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Adrenal gland]]

Michael: +cat.

2011-10-20T04:40:42Z

+cat.

← Older revision		Revision as of 04:40, 20 October 2011
Line 1:		Line 1:
	#redirect [[Adrenal gland#Neuroblastoma]]		#redirect [[Adrenal gland#Neuroblastoma]]

			[[Category:Diagnosis]]

Michael: redirect for now

2011-01-13T16:29:20Z

redirect for now

New page