Neuropathology tumours - Revision history

Jensflorian: Minor rearrangement

2022-04-14T09:04:59Z

Minor rearrangement

← Older revision		Revision as of 09:04, 14 April 2022
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	* [[Olfactory neuroblastoma]].		* [[Olfactory neuroblastoma]].
	* [[Endolymphatic sac tumour]].		* [[Endolymphatic sac tumour]].

	~~===Cystic tumours===~~
	~~DDx:<ref>URL: [http://path.upmc.edu/cases/case320/dx.html http://path.upmc.edu/cases/case320/dx.html]. Accessed on: 14 January 2012.</ref>~~
	*[[Pilocytic astrocytoma]].
	*[[Pleomorphic xanthoastrocytoma]].
	*[[Ganglioglioma]].
	*[[Hemangioblastoma]].
	*[[Craniopharyngioma]].<ref>URL: [http://www.pathologyoutlines.com/Cnstumor.html#cystsgeneral http://www.pathologyoutlines.com/Cnstumor.html#cystsgeneral]. Accessed on: 14 January 2012.</ref>

	===Primary versus secondary===		===Primary versus secondary===
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	*[[Astrocytoma, IDH-mutant]].		*[[Astrocytoma, IDH-mutant]].
	*[[Glioblastoma]], IDH-wildtype.		*[[Glioblastoma]], IDH-wildtype.

			Notes:
			**Glial: "blends into brain"/gradual transition to non-tumour brain.

	====Non-infiltrative astrocytomas====		====Non-infiltrative astrocytomas====
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	**[[Pleomorphic xanthoastrocytoma]]		**[[Pleomorphic xanthoastrocytoma]]
	**[[Subependymal giant cell astrocytoma]].		**[[Subependymal giant cell astrocytoma]].

			====Cystic tumours====
			DDx:<ref>URL: [http://path.upmc.edu/cases/case320/dx.html http://path.upmc.edu/cases/case320/dx.html]. Accessed on: 14 January 2012.</ref>
			*[[Pilocytic astrocytoma]].
			*[[Pleomorphic xanthoastrocytoma]].
			*[[Ganglioglioma]].
			*[[Hemangioblastoma]].
			*[[Craniopharyngioma]].<ref>URL: [http://www.pathologyoutlines.com/Cnstumor.html#cystsgeneral http://www.pathologyoutlines.com/Cnstumor.html#cystsgeneral]. Accessed on: 14 January 2012.</ref>


	Notes:		Notes:
	*Glial vs. non-glial tumours:
	**Glial: "blends into brain"/gradual transition to non-tumour brain.
	**Non-glial: no radiating glial processes.		**Non-glial: no radiating glial processes.
	*Rosenthal fibres within the tumour... often seen in [[pilocytic astrocytoma]].		*Rosenthal fibres within the tumour... often seen in [[pilocytic astrocytoma]].
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	*WHO Grading is currently based on expected biologiocal behaviour without treatment.		*WHO Grading is currently based on expected biologiocal behaviour without treatment.
	**Grading does not reflect molecular divergent groups within a tumor class or response to therapy (Currently controversies in grading for IDH-mutant astrocytoma vs. IDH-wildtype astrocytoma).<ref>{{Cite journal \| last1 = Louis \| first1 = DN. \| last2 = von Deimling \| first2 = A. \| title = Grading of diffuse astrocytic gliomas: Broders, Kernohan, Zülch, the WHO… and Shakespeare. \| journal = Acta Neuropathol \| volume = \| issue = \| pages = \| month = Aug \| year = 2017 \| doi = 10.1007/s00401-017-1765-z \| PMID = 28801693 }}</ref>		**Grading does not reflect molecular divergent groups within a tumor class or response to therapy (Currently controversies in grading for IDH-mutant astrocytoma vs. IDH-wildtype astrocytoma).<ref>{{Cite journal \| last1 = Louis \| first1 = DN. \| last2 = von Deimling \| first2 = A. \| title = Grading of diffuse astrocytic gliomas: Broders, Kernohan, Zülch, the WHO… and Shakespeare. \| journal = Acta Neuropathol \| volume = \| issue = \| pages = \| month = Aug \| year = 2017 \| doi = 10.1007/s00401-017-1765-z \| PMID = 28801693 }}</ref>

	~~====Images====~~
	~~Glioblastoma:~~
	~~<gallery>~~
	~~Image:Glioblastoma_%281%29.jpg \| Glioblastoma - pseudopalisading of tumour cells (WC)~~
	~~Image:Glioblastoma_-_high_mag.jpg \| Glioblastoma with fragment of near-normal white matter - high mag. (WC)~~
	~~</gallery>~~
	~~Anaplastic astrocytoma:~~
	~~<gallery>~~
	~~Image:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg \| Anaplastic astrocytoma - very high mag. (WC)~~
	~~Image:Anaplastic_astrocytoma_-_gfap_-_very_high_mag.jpg \| Anaplastic astrocytoma - GFAP - very high mag. (WC)~~
	~~</gallery>~~

	===By IHC===		===By IHC===

Jensflorian: /* Infiltrative astrocytomas */ typo

2022-04-14T09:01:43Z

Infiltrative astrocytomas: typo

← Older revision		Revision as of 09:01, 14 April 2022
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	====Infiltrative astrocytomas====		====Infiltrative astrocytomas====
	*[[Astrocytoma, IDH-mutant]].		*[[Astrocytoma, IDH-mutant]].
	*[[Glioblastoma]]IDH-wildtype.		*[[Glioblastoma]], IDH-wildtype.

	====Non-infiltrative astrocytomas====		====Non-infiltrative astrocytomas====

Jensflorian: /* By IHC */ Update

2022-04-13T12:07:12Z

By IHC: Update

← Older revision		Revision as of 12:07, 13 April 2022
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	*[[CD20]] in PCNSL.		*[[CD20]] in PCNSL.
	*Cytokeratins in Carcinoma brain metastases, Plexus choroid tumours, [[AT/RT]], [[Papillary tumour of the pineal region]], [[Craniopharyngioma]].		*Cytokeratins in Carcinoma brain metastases, Plexus choroid tumours, [[AT/RT]], [[Papillary tumour of the pineal region]], [[Craniopharyngioma]].
			*[[EMA]] in [[Meningioma]] and carcinoma brain metastases.
			*PrgR in [[Meningioma]] and carcinoma metastases.
			*[[Synaptophysin]] in glioneuronal tumours and Pituitary adenoma and embryonal tumours.

	===Common neuropathology tumours in a table===		===Common neuropathology tumours in a table===

Jensflorian: /* IHC */ Update

2022-04-13T12:04:34Z

IHC: Update

← Older revision		Revision as of 12:04, 13 April 2022
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	</gallery>		</gallery>

	===IHC===		===By IHC===
	*GFAP - should stain cytoplasm of tumour cells and the perikaryon (nuclear membrane).		*GFAP - should stain cytoplasm of tumour cells and the perikaryon (nuclear membrane) of most [[Astrocytoma]]s.
	*Ki-67 - usu. high >20% of ~~cells.~~		*[[IDH-1]](R132H) (isocitrate dehydrogenase 1) in [[Astrocytoma, IDH-mutant]].<ref name=pmid19228619>{{cite journal \|author=Yan H, Parsons DW, Jin G, ''et al.'' \|title=IDH1 and IDH2 mutations in gliomas \|journal=N. Engl. J. Med. \|volume=360 \|issue=8 \|pages=765–73 \|year=2009 \|month=February \|pmid=19228619 \|pmc=2820383 \|doi=10.1056/NEJMoa0808710 \|url=}}</ref><ref name=pmid20975057>{{cite journal \|author=Houillier C, Wang X, Kaloshi G, ''et al.'' \|title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas \|journal=Neurology \|volume=75 \|issue=17 \|pages=1560–6 \|year=2010 \|month=October \|pmid=20975057 \|doi=10.1212/WNL.0b013e3181f96282 \|url=}}</ref>
	*p53 - often +ve.		*[[H3F3A\|H3F3A K27M]] in [[Diffuse midline glioma, H3 K27-altered]].
	*[[IDH-1]] (isocitrate dehydrogenase 1).		*[[ATRX]] -ve in [[Astrocytoma, IDH-mutant]] or [[Diffuse hemispheric glioma, H3 G34-mutant]].
	**+ve in ~~tumours that arose from low~~-~~grade gliomas~~.<ref name=pmid19228619>{{cite journal \|author=Yan H, Parsons DW, Jin G, ''et al.'' \|title=IDH1 and IDH2 mutations in gliomas \|journal=N. Engl. J. Med. \|volume=360 \|issue=8 \|pages=765–73 \|year=2009 \|month=February \|pmid=19228619 \|pmc=2820383 \|doi=10.1056/NEJMoa0808710 \|url=}}</ref>		*[[CD20]] in PCNSL.
	*[[H3F3A\|H3F3A K27M]] -ve		*Cytokeratins in Carcinoma brain metastases, Plexus choroid tumours, [[AT/RT]], [[Papillary tumour of the pineal region]], [[Craniopharyngioma]].
	**+ve cases to be classified as [[Astrocytoma#H3.3_K27M_mutated_glioma_of_the_midline\|K27 mutated midline glioma]].
	*[[ATRX]] -ve in tumors with low-grade precursor(most of them also IDH1/2 mutant).

	~~Notes:~~
	*IDH1 and IDH2 mutations - better survival.<ref name=pmid20975057>{{cite journal \|author=Houillier C, Wang X, Kaloshi G, ''et al.'' \|title=IDH1 or IDH2 mutations predict longer survival and response to temozolomide in low-grade gliomas \|journal=Neurology \|volume=75 \|issue=17 \|pages=1560–6 \|year=2010 \|month=October \|pmid=20975057 \|doi=10.1212/WNL.0b013e3181f96282 \|url=}}</ref>


	===Common neuropathology tumours in a table===		===Common neuropathology tumours in a table===

Jensflorian: Cleaning up

2022-04-13T11:58:58Z

Cleaning up

Show changes

Jensflorian: /* Common neuropathology tumours in a table */ IHC update

2022-04-13T11:54:00Z

Common neuropathology tumours in a table: IHC update

← Older revision		Revision as of 11:54, 13 April 2022
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	\|variable		\|variable
	\|missed lesion / close to a lesion; non-specific pathologic process - need more tissue		\|missed lesion / close to a lesion; non-specific pathologic process - need more tissue
	\|~~nil~~		\|GFAP
	\|[[Image:Reactive_astrocytes_-_lfb_-_high_mag.jpg\|thumb\|center\|150px\|Reactive astrocytes. (WC)]]		\|[[Image:Reactive_astrocytes_-_lfb_-_high_mag.jpg\|thumb\|center\|150px\|Reactive astrocytes. (WC)]]
	\|-		\|-
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	\|old or young		\|old or young
	\|need frozen section to Dx, DDx: [[meningioma]]		\|need frozen section to Dx, DDx: [[meningioma]]
	\|S100		\|S100, SOX10
	\|[[Image:Schwannoma_-_Antoni_A_and_B_-_very_high_mag.jpg\|thumb\|center\|150px\|Schwannoma. (WC)]]		\|[[Image:Schwannoma_-_Antoni_A_and_B_-_very_high_mag.jpg\|thumb\|center\|150px\|Schwannoma. (WC)]]
	\|-		\|-

Jensflorian: /* Primary versus secondary */ Update

2022-04-13T11:53:30Z

Primary versus secondary: Update

← Older revision		Revision as of 11:53, 13 April 2022
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	[[Lymphoma]]:		[[Lymphoma]]:
			*Primary CNS Lymphoma (PCNSL) is usu. a diffuse large B-cell lymphoma.
	*Large (lymphoid) cells, ergo usu. not a difficult diagnosis.		*Large (lymphoid) cells, ergo usu. not a difficult diagnosis.
	**~2x size of resting lymphocyte, nucleoli.		**~2x size of resting lymphocyte, nucleoli.
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	====Secondary====		====Secondary====
	Carcinomas:		*Carcinomas:
	*Well-demarcated border between brain and lesion - '''key feature'''.		**Well-demarcated border between brain and lesion - '''key feature'''.
	*No cytoplasmic processes.		**No cytoplasmic processes.
	*Usu. have nuclear atypia of malignancy.		**Usu. have nuclear atypia of malignancy.
	**Nuclei often ~3-4x the size of a [[RBC]].		**Nuclei often ~3-4x the size of a [[RBC]].
	*+/-Glandular arrangement.		**+/-Glandular arrangement.
	*+/-Nucleoli.		**+/-Nucleoli.
			*Melanoma.
			*Secondary Lymphoma.
			*Sarcomas (rare).

	===Common neuropathology tumours in a table===		===Common neuropathology tumours in a table===

Jensflorian: /* By age group */ Update

2022-04-13T11:51:06Z

By age group: Update

← Older revision		Revision as of 11:51, 13 April 2022
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	#*[[Melanoma]].		#*[[Melanoma]].
	#*[[Renal cell carcinoma]] (RCC).		#*[[Renal cell carcinoma]] (RCC).
	# [[Glioblastoma]] ~~(previously known as ''glioblastoma multiforme'')~~.		# [[Glioblastoma]], IDH-wildtype.
	# [[~~Anaplastic astrocytoma~~]].		# [[Astrocytoma, IDH-mutant]].
	# [[Meningioma]].		# [[Meningioma]].

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	# [[Medulloblastoma]].		# [[Medulloblastoma]].
	# [[Ependymoma]].		# [[Ependymoma]].
			# Pontine glioma, often [[Diffuse midline glioma, H3 K27-altered]].

	===By location===		===By location===

Jensflorian: /* Common neuropathology tumours in a table */ Arabic numerals in WHO grades

2022-04-13T11:47:26Z

Common neuropathology tumours in a table: Arabic numerals in WHO grades

← Older revision		Revision as of 11:47, 13 April 2022
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	\|[[Image:Meningioma_intermed_mag.jpg \|thumb\|center\|150px\|Meningioma. (WC)]]		\|[[Image:Meningioma_intermed_mag.jpg \|thumb\|center\|150px\|Meningioma. (WC)]]
	\|-		\|-
	\|~~Infiltrative~~ [[~~astrocytoma~~]] ([[WHO]] grade II or grade ~~III~~)		\|[[Astrocytoma, IDH-mutant]] (CNS [[WHO]] grade 2 or grade 3)
	\|glial processes (esp. on smear), nuclear atypia (typical size var. ~3x, irreg. nuc. membrane, hyperchromasia), no Rosenthal fibres in the core of the lesion †, no microvascular proliferation, no necrosis		\|glial processes (esp. on smear), nuclear atypia (typical size var. ~3x, irreg. nuc. membrane, hyperchromasia), no Rosenthal fibres in the core of the lesion †, no microvascular proliferation, no necrosis
	\|often enhancing (suggests high grade), usu. supratentorial, usu. white matter		\|often enhancing (suggests high grade), usu. supratentorial, usu. white matter
	\|usu. old, occ. young		\|usu. old, occ. young
	\|common		\|common
	\|IDH-1+/-, GFAP+		\|IDH-1(R132H)+/-, GFAP+
	\| [[Image:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg \| thumb\| center\| 150px\|High-grade astrocytoma. (WC)]]		\| [[Image:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg \| thumb\| center\| 150px\|High-grade astrocytoma. (WC)]]
	\|-		\|-
	\|[[Glioblastoma]] (WHO grade IV)		\|[[Glioblastoma]], IDH-wildtype (CNS [[WHO]] grade 4)
	\|glial processes (esp. on smear), nuclear atypia (typical size var. ~3x, irreg. nuc. membrane, hyperchromasia), no Rosenthal fibres in the core of the lesion †, microvascular proliferation or necrosis		\|glial processes (esp. on smear), nuclear atypia (typical size var. ~3x, irreg. nuc. membrane, hyperchromasia), no Rosenthal fibres in the core of the lesion †, microvascular proliferation or necrosis
	\|often enhancing (suggests high grade), usu. supratentorial, usu. white matter		\|often enhancing (suggests high grade), usu. supratentorial, usu. white matter

Jensflorian: /* Gliomas */ Update

2022-04-05T10:16:14Z

Gliomas: Update

← Older revision		Revision as of 10:16, 5 April 2022
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	{{Main\|Astrocytoma}}		{{Main\|Astrocytoma}}

			* [[Astrocytoma]], IDH-mutant.
			* [[Glioblastoma]], IDH-wildtype.
			** [[Gliosarcoma]] (a glioblastoma subtype)

			Depreceated:
	* Diffuse [[Astrocytoma]]		* Diffuse [[Astrocytoma]]
	* [[Anaplastic astrocytoma]]		* [[Anaplastic astrocytoma]]
	* [[~~Glioblastoma~~]]		* [[Gliomatosis cerebri]]
	** [[~~Gliosarcoma~~]]		* Spongioblastoma

			===Oligodendroglial tumours===
			* [[Oligodendroglioma]], IDH-mutant and 1p/19q codeleted.

			Depreceated:
			* Anaplastic oligodendroglioma
			* [[Oligoastrocytoma]]
			* Anaplastic oligoastrocytoma

			===Pediatric-type diffuse high-grade glioma===
			{{Main\|Pediatric-type diffuse high-grade glioma}}
	* [[Astrocytoma#Diffuse_midline_glioma.2C_H3_K27M_mutant\|Diffuse midline glioma H3 K27-mutant]]		* [[Astrocytoma#Diffuse_midline_glioma.2C_H3_K27M_mutant\|Diffuse midline glioma H3 K27-mutant]]

	~~No longer in use:~~		===Pediatric-type diffuse low-grade glioma===
	* [[Gliomatosis cerebri]]		{{Main\|Pediatric-type diffuse low-grade glioma}}
	* Spongioblastoma

	===Circumscribed astrocytic gliomas===		===Circumscribed astrocytic gliomas===
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	</gallery>		</gallery>


	~~===Oligodendroglial tumours===~~
	* [[Oligodendroglioma]]
	* Anaplastic oligodendroglioma
	* [[Oligoastrocytoma]] (depreceated)
	* Anaplastic oligoastrocytoma (depreceated)

	~~===Pediatric-type diffuse high-grade glioma===~~
	~~{{Main\|Pediatric-type diffuse high-grade glioma}}~~

	~~===Pediatric-type diffuse low-grade glioma===~~
	~~{{Main\|Pediatric-type diffuse low-grade glioma}}~~

	===Ependymal tumours===		===Ependymal tumours===