9 y.o. headache, ataxia,

circumscribed midline cyst in cerebellum, removed surgically.

compact and loose area of slight increased cellularity

compact include long wavy fibrillar processes

+

dark pink, amorphous elongated material

locate in 3rd ventricle, cerebellu, optic nerve

Juvenile pilocystic astrocytoma

juvenile

cystic

cerebellum

mural cyst

fusiform astrocyte: long wavy fibrilar processes

rosenthal fibers: dark pink, amorphous elongated material

3rd ventricle most aggressive

pseudopalisading

necrosis

vascular proliferation

hypercellularity

pleomorphism

MRI: large lesion with central cystic change to necrosis, peripheral ring enhancement. edema and thickeneing of corpus callosum

Most common malignant primary neuro tumor in

adult:

kids

most common benign neuro tumor in kids

GM

medulloblastoma

pilocytic astrocytoma of cerebellum

8 y.o. headache, truncal ataxia,

well demarcated friable midline cyst in cerebellum, removed surgically

arise from roof of 4th ventricle and invading the vermis.

homogenous, pale gray.

hydrocephalus

medulloblastoma

PNET: primary neuroepithelial tumor

Homer Wright rosettes: tumor cells arranged radially around eosinophilic fibrillar center

60 y.o. woman, 3yh of headache, focal seizure,

CT: intracraniall mass removed surgically.

Circumscribed parasagittal mass attached to dura and compressing underlying brain.

surface of tumor bosselated

small, poorly differentiated

tumor cells arranged radially around eosinophilic fibrillar center

high N/C ratio,

hypercellular blue cell

cerebellum

kids

medulloblastoma

homer-wright rosette: tumor cells arranged radially around eosinophilic fibrillar center

parasagittal location or junction of white and gray matter

dark pink hyaline circular body

whorls

women, 45.

 transitional meningioma

psammoma body: cellular syncytial dark pink circular body

50 y.o. compalints of hearing loss, tinnitus, sensory loss in distribution of CN8, removed from vestibular nerve

low back pain and sciatica, remove from dorsal root of spinal nerve

solitary circumscribed, encapsulated eccentrically located on acoustic CN at internal audtiory meatus

bilateral

schwannoma

dumb-bell configuration: eccentrically located on acoustic CN

Neurofibromatosis Type 2

female

eccentrically away from nerve

hypercellular region

loosely cellular area with vacuolated cell

densely cellular area with nuclear palisading resembling sarcomere

usually at CP angle

vestibular region of CN8

dorsal root of spinal nerve

schwannoma

antoni A: hypercellular region

antoni B: loosely cellular area

verocay body: densely cellular area with nuclear palisading resembling sarcomere

70 y.o. woman, h/o CLL, meningeal irritation and CN palsy, spinal n. symptom

meninges involving brain and spinal cord was opaque and thickened.

CLL

hydrocephalus: meningeal infiltration by leukemic cell obstruct CSF flow

cranial/spinal nerve symptoms: leukemic cell infiltrate nerves

monomorphic lymphocyte small blue cells within meninges

infiltrating nerve root

perivascular cuffing of the cell

lack of reactive cell within CNS parenchyma

CLL infiltration

Virchow-Robin space: perivascular cuffing of the cell

DDx

CLL vs. viral meningitis

CLL:

monomorphic lymphocyte in V-R space

lack reactive cell in CNS parenchyma

Viral meningitis:

more variety of cell in V-R space

adenocarcinoma, develop headache, confusion, papilloedema, spinal cord compression.

uncal and cerebellar tonsillar herniation

rapid death

leptomeningeal carcinomatosis

ICP: headache, papilledema, vomiting

usually from lung.

more via metastatic lesion within cortex exfoliate into subarachnoid space

less commonly: hematogenous spread.

well-circumscribed

gray-white interface

cell appear thickened and fibrotic, cytoplasm within single large vacuole push nucleus to side,

MRI: ring enhancement of necrosis at center

surrounding vasogenic edema

leptomeningeal carcinomatosis

signet ring appearance: cytoplasm within single large vacuole push nucleus to side

sheets of uniform cell with centrally placed, round nuclei in clear cytoplasm

calcification of oligos

chicken wired vessels

oligodendroglioma

fried-egg appearance: sheets of uniform cell with centrally placed, round nuclei in clear cytoplasm

Diabetes Insipidus, dysfunction of anterior pituitary

loose fibrous stroma

dark-blue cord + nest of epithelial layer

either columnar cell peripherally palisaded

or stratified squamous epi

calcification

Craniopharyngioma

remnant of craniopharyngeal duct or Rathke's pouch

lesion of perivascular region and mammilary body:

acute congestion, hemorrhage, demyelinated,

vs.

brown necrosis

Wernicke's

vs.

Korsakoff's

Vit B1 - thiamine dz

at basis pontis where there are white regions u see dark regions

rapid overcorrection of hyponatremia

central pontine myelinolysis

demyelination: where there are white regions u see dark regions

shrunken folia

widened fissure of anterior and superior vermis of cerebellum

Wernicke-Korsakoff syndrome

central pontine myelinolysis

alcohlic cerebellar atrophy