2016 Annual Meeting

SC07-It’s not as Bad as it Looks: Look-Alike Lesions in Surgical Neuropathology

Room CC 618, March 17 2016, 1:00pm to 4:30pm


SC07-It's Not as Bad as It Looks: Look-Alike Lesions in Surgical Neuropathology

Session Credits: 3 CME and 3 SAMs

Bette Kleinschmidt-DeMasters, MD, University of Colorado- Denver, Denver, CO and Richard A. Prayson, MD, Cleveland Clinic, Cleveland, OH

There are a number of low grade tumors or even non-neoplastic lesions which can closely resemble each other in the central nervous system. It can be particularly challenging to distinguish these lesions from one another. In some cases, the histopathology may look worrisome for a high grade tumor when in fact the lesion is a lower grade or benign (sheep in wolfs clothing). Often the differential diagnosis requires first, knowing about the existence of these entities and the potential overlap and, second, utilizing immunohistochemistry and molecular tools to distinguish between them. The course proposes to provide a practical approach to thinking about and working through these differential diagnostic challenges. The course will place emphasis on newer antibodies that can serve to distinguish entities, and where apropos, will include recently published guidelines to classification systems, particularly of low grade gliomas. Among some the differential diagnostic challenges to be discussed include: schwannoma versus meningioma; solitary fibrous tumor/hemangiopericytoma versus meningioma; chordoma versus chordoid meningioma; hemangioblastoma versus metastatic renal cell carcinoma; the dreaded gliosis versus glioma; anaplastic oligodendroglioma versus small cell astrocytoma/glioblastoma; and low grade glioma versus low grade glioneuronal tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor).

Upon completion of this educational activity, participants should be able to:

  1. Recognize common pathologic features associated with certain low grade tumors or non-neoplastic conditions arising in the central nervous system
  2. Generate a differential diagnosis for certain low grade tumors or non-neoplastic conditions
  3. Differentiate between differential diagnostic considerations based on morphology, immunohistochemistry and/or molecular testing.


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