I discuss issues pertaining to the practice of neuropathology -- including nervous system tumors, neuroanatomy, neurodegenerative disease, muscle and nerve disorders, ophthalmologic pathology, neuro trivia, neuropathology gossip, job listings and anything else that might be of interest to a blue-collar neuropathologist.
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.
Wednesday, March 22, 2017
An update on SF-1 driven pituitary adenomas
Adenomas
driven by the transcription factor SF-1, which are exclusively gonadotroph
adenomas, are a common subtype encountered by the surgical pathologist.
Traditionally, gonadotroph adenomas have been defined by positive
immunostaining for luteinizing hormone (LH) and/or follicle stimulating hormone
(FSH) with or without alpha-subunit (αSU). However, evidence is now emerging
that replacement of these three immunostains by the single SF-1 stain results
in a more cost-effective and sensitive means of detecting gonadotrophin
adenomas. Further, the majority of previously classified "null cell"
adenomas -- negative for all hormonal markers including LH, FSH and αSU -- are
in fact positive for SF-1 and therefore better classified as gonadotroph
adenomas.
Tuesday, March 21, 2017
"Gross only" sign out of intraocular lens prosthesis
When signing out our gross only IOL cases, my ophthalmologists want me to comment as to whether the "haptics" are completely present to confirm that nothing has been inadvertently left behind in the patient. If you are wondering what a "haptic" is, it the curving blue filament that emerges from the prosthetic lens serving to keep the lens in place. The term "haptic" means "related to the sense of touch"; but I am not sure why this term is used in this context. Perhaps a reader knows?
IOL with blue haptics in place |
Thursday, March 16, 2017
Retinal biopsy from an elderly woman with suspected ocular lymphoma
The patient had multiple foci of markedly thickened retina on exam. Ophthomologists were able to obtain a relatively large retinal biopsy. We did not find lymphoma in this case, and infections of many sorts were ruled out. But the ophthalmologists wanted an opinion as to whether retinal vasculitis was present. I wonder whether the threshold for calling vasculitis in the retina should be lower than in other tissues. Your input in the comments section would be greatly appreciated.
Low power view |
Medium power showing diffuse edema |
Arterioles with focus of intramural inflammatory infiltrate on right side of right vessel |
Wednesday, March 8, 2017
Emory Neuropathologist Dan Brat delivers Nathan Kaufman Timely Topics Lectures at 2017 USCAP annual meeting
On Monday, March 6, Dan Brat, MD, PhD delivered a presentation entitled "Platforms, Diagnosis and Disease: An Evolution Rooted in Pathology" to attendees of the 2017 annual meeting of the United States and Canadian Academy of Pathology (USCAP) in San Antonio, Texas. Dr. Brat is director of the neuropathology division of the Emory University pathology Department.
Tuesday, March 7, 2017
Johns Hopkins Atlas of Surgical Neuropathology now available on iTunes
Dr. Eberhart |
Dr. Rodriquez |
Friday, March 3, 2017
Why is the confluence of the cerebral venous sinuses called the "torcula"?
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.
Source: https://www.dmu.edu/dose/2009/11/anatomy-word-of-the-month-torcular-herophili/
Source: https://www.dmu.edu/dose/2009/11/anatomy-word-of-the-month-torcular-herophili/
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