a case for discussion (part 1).pdf

8/13/2019 A case for discussion (part 1).pdf

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CLINICAL PICTURE


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COMPUTED TOMOGRAPHY

Lateral ventricle is occupied by partially filling mass isodense to grey

matter, with an area of hyperdensity that can match the calcification.

Moderate dilatation of the lateral ventricles. There is weak impregnation

by contrast


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MAGNETIC RESONANCE IMAGING

Mass located within lateral ventricle; partially filling the body and the

trigone, apparently deployed at the level of the foramen of Monro. It causes

deviation of septum pellucidum and bilateral ventricular dilation. The mass is

well delimited, loose, heterogeneous.

AXIAL CUTS


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Part of the mass is solid, suggesting a high degree of hydration. There

are discrete contrast uptake.

FLAIR


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CORONAL T1 CUTS, Without CONTRAST


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The tumor is formed of small cells interspersed by thin walled blood vessels and several

calcareous concretions, but no necrosis.


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CELLULAR AREAS


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Tumor in the vicinity of ependyma. Neoplastic Cells approach the

ventricular surface in this area, without forming a precise limit


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The tumor showing high degree of uniformity in the various areas,

composed of cells with round nuclei and clear cytoplasm.


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Regular nuclei, clear perinuclear halo pattern, rare mitoses.


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The cells are small, rounded, very regular clear perinuclear halo (fried egg in ' aspect '),


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Cells with a perfectly round nucleus, surrounded by either a clear halo (as in

oligodendroglioma) or by pale cytoplasm (chondroblastoma).


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The nuclei are round with regularly distributed (salt and pepper) chromatin: granular

finely speckled chromatin, which is evenly distributed throughout the

nucleus; consists of intermixed finer and larger particles and, some with a small

nucleoli. The cytoplasm is scanty,


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Small nucleoli and a rare mitosis


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Homer Wright Rosettes (fibrillary or neuroblastic rosettes) have a central tangle of

fibrillar processes (neuropil). There is no central vessel or lumen.

Pink fibrillar and anucleated islets amid mass of neoplastic cells, geographic or rounded

outline. The pseudorosettes are formed by cytoplasmic extensions of neoplastic cells


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VASCULAR AREAS

Branching and anastomosing network of vessels


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Delicate Vessels in dichotomic branch.

Tumor capillaries are thin, regularly spaced, and create a perfectly interanastomosing

network that mimics ' aspect of screen chicken coop of oligodendrogliomas The

abundance of these small vessels makes highly tumor bleeding in surgical approach.


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Delicate vessels and numerous in dichotomic branch, creating a network

classically compared the ' screen of chicken coop '.


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Thin, rectilinear, delicately-branched, with cores of endothelial cells

spaced, without signs of vascular proliferation


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Areas of calcification


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The calcareous concretions of varied size and may become confluent


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Abundant calcareous Concretions in certain area


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YOUR WISH LIST??

a case for discussion (part 1).pdf

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