Download e-book for kindle: Biopsy Interpretation of the Central Nervous System by Matthew J. Schniederjan MD, Daniel J. Brat MD PhD

By Matthew J. Schniederjan MD, Daniel J. Brat MD PhD

This can be a useful advisor and concise reference that may be a better half textual content for the final surgical pathologist, trainees in pathology and neuropathology, and clinicians who deal with sufferers with neurological ailments that require surgical sampling.

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It generally occurs in adults as an extra-axial mass, although intraparenchymal location has been reported [79], as has a pediatric case [80]. The presentation parallels that of meningiomas, being a dural mass that enhances after gadolinium administration. Most patients with Rosai–Dorfman disease are cured after surgical resection, although some cases may behave aggressively [81, 82]. Radiation and corticosteroids are also sometimes used. Histopathology CNS lesions in Rosai–Dorfman disease contain similar mixed inflammatory cell infiltrates as peripherally located lesions but are generally more fibrotic.

INFLAMMATORY AND INFECTIOUS LESIONS ——— 33 ROSAI–DORFMAN DISEASE Clinical Context CNS cases of extranodal sinus histiocytosis are rare, with only a few dozen in the literature, mostly as case reports. In contrast to Langerhans cell histiocytosis, which is clonal and neoplastic, Rosai–Dorfman disease is an idiopathic, polyclonal inflammatory lesion [78]. It generally occurs in adults as an extra-axial mass, although intraparenchymal location has been reported [79], as has a pediatric case [80]. The presentation parallels that of meningiomas, being a dural mass that enhances after gadolinium administration.

46 ——— BIOPSY INTERPRETATION OF THE CENTRAL NERVOUS SYSTEM FIGURE 3-8 Granular cell astrocytomas also typically have lymphocytic perivascular infiltrates that add to the illusion of a demyelinating lesion. by positive immunostaining for CD68, a lysosomal protein. HAM56 is a nonlysosomal marker of histiocyte/macrophage differentiation that has also been shown to be strongly expressed in neoplastic astrocytes, although this has not been specifically and systematically tested in granular cell astrocytomas [25].

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