Thursday, August 17, 2017

Best Post of June 2017: Additional photograph of remarkable CNS/PNS dissection

The next in our "Best of the Month" series is from June 12, 2017:


Taken by our staff photographer, Lisa Litzenberger.

Tuesday, August 8, 2017

College of American Pathologists Neuropathology Committee met in Monterey, CA this past weekend

The College of American Pathologists Neuropathology (CAP-NP) Committee met in Monterey, CA this past weekend.  We are making plans for our next SAM-eligible educational product that will, among on things, update you on the latest World Health Organization system of pituitary adenoma classification. After a long day at work on the CAP-NP educational product, committee members retired to a nearby restaurant where this picture was snapped:


Some of the CAP Neuropathology Committee members (left to right, in the foreground)" Brett Harris, Andrea Weins, Areli Cuevas-Ocampo, Matt Scheiderjan (standing), Eyas Hattab (seated), and Rania Hattab (wife of Dr. Eyas Hattab)


Friday, July 14, 2017

Best Post of May 2017 - Guest Post: A Case from the Hawkeye State

The next in our "Best of the Month" series is from May 19, 2017:


From the illustrious Dr. Karra Jones of the University of Iowa:

Karra Jones, MD, PhD
40 year old female with progressive headaches over 6-8 months. MRI showed a large cystic and solid mass, favored to be extra-axial and arising from the anterior skull base just left of midline with possible dural attachment. Sections showed a densely cellular mass arranged in a mostly haphazard, slightly fascicular pattern. Alternating hypercellular and hypocellular areas were seen. Tumor cells were ovoid to spindle shaped with scant eosinophilic cytoplasm. No eosinophilic bands of wire-like collagen were noted, and only focal staghorn-like vasculature was identified. Only up to 3 mitotic figures were enumerated in 10 hpf counts. No necrosis was identified. You can see the diagnosis in the comment section after considering the photographs below:

Axial MRI T1 Post-Contrast





CD34


CD34

STAT6

Wednesday, July 5, 2017

Best Post of April 2017: Screenshots of the surgical neuropathology volume of the Johns Hopkins Atlases of Pathology


The next in our "Best of the Month" series is from April 6, 2017:

A month ago I put up a post regarding the release of Volume 3 of the Johns Hopkins Atlases of Pathology for the iPad. This app only costs $4.99 .  Here are some screenshots of the app provided to me by series editor Toby Cornish, MD, PhD:





Thursday, June 22, 2017

Which subtypes of pituitary adenoma must you be aware of as tending to be more clinically agressive?

Certain subtypes of pituitary adenoma have been shown to be more clinically aggressive in that they tend to be more invasive, have earlier recurrence, and are more resistant to treatment. The following adenoma subtypes are recognized as having a more aggressive clinical behavior:

- Acidophil stem cell adenoma
- Crooke cell adenoma
- Lactotroph adenoma when occurring in men
- Pit-1 positive plurihormonal adenoma
- Sparsely granulated somatotroph adenoma
- Silent corticotroph adenoma

Thanks to Dr. Bea Lopes of the University of Virginia for consulting on the compilation of list!

Best Post of March 2017: Why is the confluence of the cerebral venous sinuses called the "torcula"?


The next in our "Best of the Month" series is from March 3, 2017:


Torcula is derived from a Latin word meaning to “twist” and was also used to refer to a wine press. Within the cranium the venous sinuses come together at the back of the skull in a structure called the confluence of the sinuses. This cavity has four large veins radiating from it, supposedly resembling the spigots that pour dark purple juice out of the four sides of the ancient wine press used to squeeze grapes with a handled screw on the top. The same stem is found in common words such as torture and tortuous.

Monday, June 12, 2017

Additional photograph of remarkable CNS/PNS dissection



I wanted to share this additional photo related to the last post. It was taken by our staff photographer, Lisa Litzenberger.

Wednesday, June 7, 2017

Remarkable en bloc dissection of human central and peripheral nervous system accomplished at University of Colorado

Shannon Curran, MS with her dissection
Shannon Curran, a graduate student in the Modern Human Anatomy Program at the University of Colorado Anschutz Medical Campus, recently completed an en bloc dissection of the central nervous system along with an extensive portion of the peripheral nervous system from a human cadaver donor.  "It's pretty amazing," said Assistant Professor Maureen Stabio "There are only a handful of these prosections in the world ... We are so lucky to have such talented and ambitious students on our campus."

Curran, who is known among students and faculty as a preternaturally efficient prosector, completed the dissection in under 100 hours. Further detailed work is planned on the specimen, including dissection of the extraocular muscles away from the eyeballs while maintaining their connection to the brain. Discussion is underway about loaning the specimen to the Denver Museum of Nature and Science for community health education.

CNS en bloc dissection with extensive portion of PNS



Connection to the eyeballs is maintained, with plans to dissect away extraocular muscles



Detail showing maintained connection with digital nerves of the left hand


Saturday, June 3, 2017

Prominent Neuropathologist Dan Brat named Pathology Chair at Northwestern

Leading neuropathologist Dan Brat, MD, PhD has been named chair of the pathology department at Northwestern University Feinberg School of Medicine

Daniel Brat, MD, PhD
Brat has been serving as professor and vice chair for Translational Programs in the Department of Pathology and Laboratory Medicine at Emory University School of Medicine.
Brat joins a lengthening list of neuropathologists who are departmental chairs. The list includes:
Douglas Anthony at Brown

Jennifer Baccon at Akron

Steven Carroll at Medical University of South Carolina

Robert Corona at SUNY Upstate

Jeffrey Golden at Brigham and Women's Hospital

Eyas Hattab at University of Louisville

Alex Judkins at Children's Hospital Los Angeles

David Louis at Massachusetts General Hospital

Jenny Libien at SUNY Downstate

Thomas Montine currently at University of Washington and soon to be at Stanford

Edwin Monuki at the University of California Irvine

Robert Mrak at the University of Toledo

Amyn Rojiani at Augusta University

Kevin Roth at Columbia

John Schweitzer at East Tennessee State University

Best of luck to Dan in his new adventure leading one of the most prominent pathology departments in the country!

Thursday, June 1, 2017

Best Post of February 2017: Hunched Over a Microscope, Santiago Ramon y Cajal Sketched the Secrets of How the Brain Works

The next in our "Best of the Month" series comes from February 20, 2017:



Last month, the Weisman Art Museum in Minneapolis opened a traveling exhibit that is the first dedicated solely to Ramón y Cajal’s work. According to a New York Times article, it will make stops in Minneapolis; Vancouver, British Columbia; New York City; Cambridge, Mass.; and Chapel Hill, N.C., through April 2019.

Ramon y Cajal in his laboratory, circa 1885
 Thanks to Drs. Mark Cohen and John Evans for alerting me to this exhibit.

Friday, May 19, 2017

Guest Post: A Case From the Hawkeye State

From the illustrious Dr. Karra Jones of the University of Iowa:

Karra Jones, MD, PhD
40 year old female with progressive headaches over 6-8 months. MRI showed a large cystic and solid mass, favored to be extra-axial and arising from the anterior skull base just left of midline with possible dural attachment. Sections showed a densely cellular mass arranged in a mostly haphazard, slightly fascicular pattern. Alternating hypercellular and hypocellular areas were seen. Tumor cells were ovoid to spindle shaped with scant eosinophilic cytoplasm. No eosinophilic bands of wire-like collagen were noted, and only focal staghorn-like vasculature was identified. Only up to 3 mitotic figures were enumerated in 10 hpf counts. No necrosis was identified. You can see the diagnosis in the comment section after considering the photographs below:

Axial MRI T1 Post-Contrast





CD34


CD34

STAT6

Tuesday, May 16, 2017

Best Post of January 2017: Corneal ulceration secondary to Candidal keratitis

The next in our "Best of the Month" Series is from January 20, 2017. A good photomicrograph is worth a thousand words.


GMS stain highlights fungal forms in the corneal stroma

Wednesday, May 3, 2017

Diagnostic Slide Session cases have been released by AANP

The American Association of Neuropathologists has released the cases for the 2017 Diagnostic Slide Session, which will be held at the association's annual meeting on Saturday, June 10 from 8 to 11 pm. The session, which will be moderated by Drs. Caterina Giannini Rebecca D. Folkerth, focuses on a discussion of 10 cases submitted by members from far and wide.


Monday, April 24, 2017

Best Post of December 2016: Fibrous Bodies Nicely Demonstrated in a Smear from a Somatotroph Pituitary Adenoma

The next in our "Best of the Month Series" is from December 2, 2016:

Christian Davidson, MD

Dr. Christian Davidson, director of neuropathology at the Robert Wood Johnson University Hospitalin New Jersey, provides today's blog post:

A 30-year-old man presented with bitemporal hemianopsia and a 3.0 cm pituitary mass was discovered upon MRI. His IGF-1 was elevated to 900, but he had no signs of acromegaly. A smear of tissue sent for frozen section evaluation (see below) revealed that most cells had round, eosinophilic, perinuclear inclusions suggestive of fibrous bodies (some examples are circled). Dot-like CAM5.2 immunostain (not shown) confirmed my smear-based diagnostic suspicion.


Thursday, April 6, 2017

Screenshots of the surgical neuropathology volume of the Johns Hopkins Atlases of Pathology

A month ago I put up a post regarding the release of Volume 3 of the Johns Hopkins Atlases of Pathology for the iPad. This app only costs $4.99 .  Here are some screenshots of the app provided to me by series editor Toby Cornish, MD, PhD:








Friday, March 24, 2017

This slow growing "pineal mass" was thought by radiologists to be a pineocytoma



Not definitively attached to the dura, but the neuroradiologist wisely put meningioma on the differential diagnosis. Microscopy showed WHO grade I meningioma.