| Image |
Slide # |
Tissue |
Mag |
Feature |
 |
1 |
Cerebellum |
LP |
Cerebellar Astrocytoma, compact and loose
areas of slightly increased cellularity (too many nuclei). |
 |
3 |
Cerebellum |
HP |
Same. The cells
are more easily distinguished as astrocytic (many appear as fusiform astrocytes
with long wavy fibrillar processes and others as stellate astrocytes).
Also note the dark pink, amorphous elongated materiall which are Rosenthal
fibers (not specific). Features of discrete nature, slow growth, elongated
cells, cystic change and Rosenthal fibers are features shared by cerebellar,
juvenile third ventricular, and optic nerve lesions. |
 |
4 |
MRI with contrast |
HP |
Cerebellar astrocytoma exhibiting cystic
change and enhancement with contrast |
 |
5 |
Cerebrum (slide 171) |
LP |
Glioblastoma multiforme. Note moderate
to marked hypercellularity and focus of necrosis with pseudopalisading. |
 |
6 |
Cerebrum |
MP |
Glioblastoma multiforme.
Central necrosis surrounded by viable tumor nuclei giving appearance of
palisading which is called pseudopalisading. Necrosis is found in glioblastoma
multiformed but not anaplastic astrocytoma. |
 |
7 |
Cerebrum |
MP |
Glioblastoma multiforme. Most frequent
primary brain neoplasm in adults. |
 |
8 |
Cerebrum |
HP |
Glioblastoma multiforme. Note moderate
to marked hypercellularity, mitoses, and moderate pleomorphism (often even
more pleomorphic). |
 |
9 |
Cerebrum |
HP |
Same. Also note vascular
proliferation (endothelial proliferation is a feature that is often present
but not required for diagnosis). |
 |
10 |
MRI |
HP |
Large lesion with central cystic change
corresponding to necrosis and peripheral ring enhancement. Notice surrounding
edema and thickening of corpus callosum secondary to tumor infiltration. |
 |
11 |
Cerebellum (slide 81) |
MP |
Medulloblastoma or PNET. Most frequent
malignant brain tumor in children. Note marked hypercellularity of small,
dark blue cells without definite architectural pattern. |
 |
12 |
Cerebellum |
HP |
Medulloblastoma.
Note closely spaced cells with angular, hyperchromatic, carro-shaped nuclei.
Necrosis is seen as individual pyknotic nuclei. Mitoses are frequent and
there are few Homer Wright rosettes with central eosinophilic fibrillar
material. (Vascular endothelial proliferation may also be present as in
this slide.) |
 |
13 |
MRI |
HP |
Central vermal tumor |
 |
14 |
Brain (slide 177) |
Gross |
Meningioma. Note common parasagittal location.
Note compression but not invasion of the brain. |
 |
15 |
Brain |
LP |
Meningioma. Note whirling
pattern of tumor cells and psammoma bodies (round dense purple structures). |
 |
16 |
Brain |
MP |
Same. |
 |
17 |
Brain |
MP |
Meningioma. Whorls of cells and elongated
cells. No psammoma bodies. |
 |
18 |
Brain |
HP |
Same. |
 |
19 |
MRI |
HP |
Parasagittal enhancing dural-based tumor |
 |
20 |
Cranial n. (slide 178) |
Gross |
Schwannoma. Note discrete lesion with
nerve fibers stretched over the tumor capsule (not in tumor). May arise
from cranial nerves (esp 8th), spinal nerves, or extra-spinal nerve roots. |
 |
21 |
Cranial n. |
LP |
Schwannoma. Antoni A, dense
cellular area, and Antoni B, loosely structured area. |
 |
22 |
Cranial n. |
MP |
Schwannoma. Antoni A, densely cellular
area with nuclear palisading or Verocay body. |
 |
23 |
Cranial n. |
MP |
Schwannoma. Antoni A, densely cellular
area, no Verocay body. |
 |
24 |
Cranial n. |
HP |
Schwannoma. Antoni B, loosely
cellular areas with vacuolated cells with round or oval nuclei. |
 |
25 |
MRI |
HP |
Enhancing large, well-circumscribed tumors
localized to cerebellopontine angle |
 |
26 |
Spinal cord (slides 163 & 164) |
LP |
Chronic lymphocytic leukemia. Note numerous
small blue cells within the meninges. |
 |
27 |
Spinal cord |
HP |
CLL. Note increase in monomorphic lymphocytes
within meninges. (Monomorphic appearance better seen on later photomicrograph). |
 |
28 |
Spinal cord |
LP |
CLL. Cells are infiltrating spinal nerve
roots. |
 |
29 |
Spinal cord |
MP |
CLL. Same |
 |
30 |
Spinal cord |
HP |
CLL. Perivascular
cuffing of monomorphic lymphocytes. (All lymphocytes look similar and there
are no other types of cells such as macrophages or plasma cells.) Also
note the lack of reactive cells within the CNS parenchyma (another distinguishing
feature from viral encephalitis). |
 |
32 |
Brain |
|
Metastatic carcinoma. Note
the relatively discrete nature of the metastatic lesion. Also note the
compression of the ventricle and compressed sulci. In addition to tumor
mass, swelling would result in increased intracellular pressure. |
 |
33 |
Brain |
LP |
Metastatic carcinoma. Note relatively
well defined nature of the metastatic tumor. |
 |
34 |
Brain |
MP |
Metastatic carcinoma. The
tumor can now be seen to be an adenocarcinoma. |
 |
35 |
Brain |
|
Metastatic carcinoma. Again note discrete,
well defined tumor. |
 |
36 |
MRI |
|
Multiple enhancing nodules at gray-white
interface with surrounding vasogenic edema |
 |
39 |
Brain (demo slide) |
HP |
Oligodendroglioma. Sheets
of uniform cells with centrally placed, round nuclei often in clear cytoplasm
giving a fired egg appearance. Calcification which is present in 90% of
oligos is not seen. |
 |
40 |
Brain |
HP |
Same. |
 |
41 |
MRI |
HP |
Enhancing tumor infiltrating cortex |
 |
42 |
Brain (demo slide 9) |
LP |
Craniopharyngioma. Epithelium can abe
solid and assume an adamantinomatous pattern (trabeculae, cloverleafs,
etc with peripherally palisaded, columnar epithelial cells) or line cysts
and form stratified squamous epithelium. Reactive stroma and clacification
are common. (Origin: remant of craniopharyngeal duct or Rathke's pouch). |
 |
44 |
Brain |
|
Wernicke-Korsakoff encephalopathy. Not
pigmentation of gray matter around third ventricle. Occurs with Vitamin
B1 deficiency, most often in chronic alcoholics. |
 |
45 |
Mammillary |
|
Wernicke's encephalopathy. Note bodies
black mammillary body from acute congestion and hemorrhage indicating the
acute form or Wernicke's. |
 |
46 |
Mammillary bodies |
|
Korsakoff's disease. Shrunken,
bodies brown mammillary bodies indicating chronic stage or Korsakoff's
disease. |
 |
47 |
Pons and Cerebellum |
|
Central pontine myelinolysis. Demyelination
of the center of the basis pontis. Cause is unknown but is usually in chronic
alcoholics and is often associated with rapid over-correction of hyponatremia. |
 |
48 |
Cerebellum |
|
Alcoholic cerebellar atrophy. Shrunken
folia and widened fissures of the anterior, superior vermis of the cerebellum.
Another change which may be found in chronic alcoholics. |