Case 1 - Click here for Text and References
Submitted by: Ty W. Abel
Clinical Summary:
The patient is a forty-one-year-old woman with a history of endometrial carcinoma, and an 8-month history of headache, vomiting, and ataxia.
T2-weighted, axial MRI. The “striped” cerebellum
H&E
H&E Stain. Vacuolated white matter
H&E Stain. Hypertrophy of granule cells
H&E Stain. Hypertrophy of granule cells
H&E Stain. Hypertrophy of granule cells
H&E Stain. Dyplastic Gganglion cells
H&E Stain. Coarse Calcification
Luxol Fast Blue/PAS Stain. Abnormally myelinated axons in molecular layer
Case 2 - Click here for Text and References
Submitted by: Charles Eberhart
Clinical Summary:
This 11 month old child presented with progressive lethargy and emesis. After preliminary testing an MRI was obtained, followed by resection of the lesion identified.
MRI – A heterogeneously enhancing lesion is present within the cerebellar parenchyma.
40X HE - Low magnification images show a cellular small round blue cell tumor containing scattered round to oval paler regions.
100X Syn – Synaptophysin immunostains reveal neuronal differentiation in the cells making up the nodules.
200X GFAP – Scattered tumor cells express the glial marker GFAP.
200X HE – The pale nodules are composed of cells with more cytoplasm than the surrounding regions.
200X p53 – Immunoreactivity for p53 is more pronounced in the internodular regions. Apoptotic bodies within nodules are also prominent in this image.
400X GFAP – Scattered tumor cells express the glial marker GFAP.
400X HE – Many tumor cells in the nodules (upper portion of image) show elongated processes, with interspersed apoptotic cells showing condensed chromatin. In the internodular region (lower portion of image) tumor cells frequently mold against one another.
400X Reticulin – Reticulin fibers are absent within nodules but abundant elsewhere.
Case 3 - Click here for Text and References
Submitted by: Tarik Tihan
Clinical Summary:
The patient is a 6-year-old boy who presented with headaches, nausea and vomiting. A neurological examination failed to reveal any localizing signs. An ophthalmological evaluation revealed bilateral papilledema. An MRI revealed a solid, uniformly enhancing mass within th hypothalamic/chiasmatic region which extended into the third ventricle causing significant hydrocephalus. An endoscopic biopsy was performed.
Pertinent Laboratory Data:
All preliminary laboratory tests were unremarkable including a CSF analysis. Representative images from the radiological study are presented.
MRIT1gad
MRIflair
MRIcoronalT2
H&E
Case 4 - Click here for Text and References
Submitted by: Gregory N. Fuller
Clinical Summary:
A 57-year-old man presented with a several month history of general malaise and anorexia, with recent onset of loss of his sense of smell and increased sweating. Subsequent MR imaging revealed a mass lesion in the third ventricle.
Case 4 - Slide 1
Axial T1-weighted MR image with contrast. A circumscribed, contrast-enhancing mass is seen in the rostral 3rd ventricle.
Sagittal T1-weighted MR image with contrast. A circumscribed, contrast-enhancing mass is seen in the rostral 3rd ventricle in the region of the lamina terminalis.
H&E (x5). The mass is composed of cords and nests of cells separated by a prominent myxoid matrix.
H&E (x10). The mass is composed of cords and nests of cells separated by a prominent myxoid matrix.
H&E (x20). The mass is composed of cords and nests of cells separated by a prominent myxoid matrix.
Case 5 - Click here for Text and References
Submitted by: Peter C. Burger
Clinical Summary:
A 70-year-old woman presented with a very rapidly enlarging, contrast-enhancing right parietal lobe mass.
