Netter Pituitary Hormone Illustration

If you're delivering a lecture on the pituitary gland, you might find this illustration useful to include in your PowerPoint presentation:

IDH1 Mutations in Oligodendrogliomas: PNA-clamping PCR is best analytic method

This is just out from a Korean group headed by Dr. Se-Hoon Kim publishing online in Brain Pathology:

Although direct sequencing of mutations in isocitrate dehydrogenase 1 (IDH1) has been considered to be the gold standard method to detect this mutation, the sensitivity of this technique has been questioned especially because specimens from glial tumors may contain large numbers of non-tumor cells. The group screened 141 cases of oligodendroglial tumors for IDH1 mutations using peptide nucleic acid (PNA)-mediated clamping PCR and compared the results with the results of direct sequencing, pyrosequencing, and immunohistochemistry (IHC). Nested PCR was only performed in cases having mutant IDH1 only discovered by clamping PCR. Using dilution experiments mixing IDH1 wild-type and mutant DNA samples, clamping PCR detected mutations in samples with a 1% tumor DNA composition. Using PNA clamping PCR, the group detected 138 of 141 (97.9%) cases with mutant IDH1 in the series, which is significantly higher (P = 0.016; PNA clamping vs. direct sequencing) than those of direct sequencing (74.5%), pyrosequencing (75.2%), and IHC (75.9%). From these results, it appears that almost all oligodendroglial tumors have IDH1 mutations, suggesting that IDH1 mutation is an early and common event especially in the development of oligodendroglial tumors.

Dramatic meningioma manifestations

Orbitocranial extension of meningioma

Massive cranial extension

Nasal extension of meningioma

Massive frontal lobe meningioma

A 32-year-old HIV+ male presenting with mental status changes

 Soon after admission, the patient lapsed into a coma and died.

Minimal edema (brain weight: 1500 grams)

Some hypoxic-ischemic damage as evidenced by Purkinje red neuron change

"Soap bubble" changes around some vessels (sample from basal ganglia)

Giant cells among mixed inflammatory infiltrate in the meninges

Inflammation appears to extend minimally into brain parenchyma

Organisms consistent with crytopcoccus neoformans amid inflammation

Mucicarmine-positive fungi capsules highlighted in red, with some capsules partially deficient

Diagnosis: Cryptococcal meningoencephalitis with early hypoxic-ischemic encephalopathy.