By Ashraf Khan
Surgical pathology is the cornerstone within the administration of neoplastic issues. Written for the working towards surgical pathologist in brain, Surgical Pathology of Endocrine and Neuroendocrine Tumors offers an updated textual content on surgical pathology of endocrine and neuroendocrine tumors. The textual content starts with radiological imaging of tumors, via a piece on effective needle aspiration biopsy. the most part specializes in surgical pathology of endocrine and neuroendocrine tumors. the quantity closes with purposes of molecular ideas and their strength for the longer term. Surgical Pathology of Endocrine and Neuroendocrine Tumors is written by means of a panel of across the world famous pathologists who're not just specialists of their fields, yet who additionally give a contribution their very own priceless insights making this new booklet an important source for practising normal and professional surgical pathologists and pathologists in training.
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Extra resources for Surgical Pathology of Endocrine and Neuroendocrine Tumors (Current Clinical Pathology)
Suprasellar) • Dermoid: posterior fossa, midline lesions, 4th ventricle • Macroscopic pathology • May see filamentous-like masses of nucleoprotein ◦ Epidermoid: smooth, translucent cyst, when open has flaky contents • Positive for EMA and cytokeratin markers by immunohistochemistry ◦ Dermoid: thicker capsule with pilosebaceous contents • Microscopic pathology B. Rathke’s cleft cyst • Intrasellar or suprasellar • Often incidental finding, larger ones may be symptomatic causing visual disturbances or abnormalities of hypothalamic pituitary function • Histologically lined by ciliated columnar epithelium, may see squamous metaplasia C.
Medulloblastoma • Peak in 1st decade, 70% occur in children <16 yr • Males > females • Most arise in vermis and project into 4th ventricle • Clinical presentation most commonly ataxia, gait disturbance, headache, vomiting • WHO grade IV tumor • Typical histopathology marked by densely packed cells with high nuclear-to-cytoplasmic ratio • Homer Wright pseudorosettes <40% of cases • Mitoses frequent, apoptosis frequent • Necrosis common • Desmoplastic variant marked by nodular, reticulin-free zones (pale islands) surrounded by more densely cellular areas (reticulin rich) • Nodular variant marked by intranodular nuclear uniformity, cell streaming, neurocytic-like cells 27 • Large cell variant marked by large, pleomorphic cells with prominent nucleoli • Medullomyoblastoma marked by focal myogenic differentiation • Melanotic medulloblastoma marked by melanotic cells, often epithelial in appearance and forming tubules • Many stain with synaptophysin antibody; subset GFAP positive • Cytogenetics: about half with isochromosome 17q, loss of part of 17p in 30–45%, loss on 1q and 10q in 20–40% • 5-yr survival—50–70% • Poor prognosis associated with young age (<3 yr), metastasis at presentation, subtotal resection, large cell variant, melanotic variant D.
Synovial cysts of spine ◦ Epidermoid: keratin debris, keratohyaline granules, and delicate epithelial lining ◦ Dermoid: epithelial-lined cyst with sweat and sebaceous glands ◦ Cysts can rupture and elicit a foreignbody giant-cell reaction to their contents X. Miscellaneous Tumors A. Paraganglioma • Most present as spinal intradural tumors in the cauda equina region • Intracranial tumors usually represent extensions of jugulotympanic tumors • Mean age 40–50 yr, males > females • Often present with lower back pain • WHO grade I tumor • Composed of chief cells arranged in nests or lobules (zellballen) surrounded by a single layer of sustentacular cells • May encounter mild pleomorphism, occasional mitotic figures, and rarely foci of hemorrhagic necrosis • Chief cells stain with synaptophysin, chromogranin, and neurofilament proteins • AKA: ganglion cyst • Sustentacular cells stain with S-100 protein • Intradural, extramedullary lesions associated with degenerative joint disease • Most in cauda equina are slow growing and potentially curable by total excision 31 CHAPTER 3 / TUMORS • Cannot predict behavior of tumor based on histology B.