Pathology of CNS tumors for preclinical medical students.

6. In every person who comes near you look for what is good and strong; honor that; try to learn it, and your faults will drop off like dead leaves when their time comes. --John Ruskin Look for good in others “No one is without faults and everyone has some good qualities…!”

7. Pathology of CNS Tumors Dr. Venkatesh M. Shashidhar, MD Associate Professor & Head of Pathology

11. CNS Anatomy - Clinical Features

15. Meningioma

16. Meningioma

17. Meningioma

18. Meningioma

19. Meningioma

20. Meningioma

22. Meningioma – whorls of clear cells. Normal Arachnoid Granulation

23. Meningioma Nodules Psammoma Body

24. Psammoma bodies (calcification)

27. Astrocytoma-Lowgrade fibrillary

28. Astrocytoma

29. Astrocytoma: * Lat. Vent. *petechial hem.

30. Glioma Brain Stem – note diffuse tumor

31. Glioma Cerebrum cystic degeneration

32. Glioma:

33. Astrocytoma (Glioma)

34. Glioma Brain Normal

35. Astrocytoma

38. Genetic abnormalities in Glioma: Low grade  Anaplastic  GBM

39. Glioma: high grade

40. Glioma: Enhancement with peritumoral edema.

41. Glioblastoma:

42. GBM: + glioma Enhancement with peritumoral edema.

43. Glioblastoma – high grade Astrocytoma

44. Glioblastoma – high grade Astrocytoma

45. Glioblastoma Multiforme (high grade Astrocytoma)

46. Glioblastoma Cerebrum

47. Glioblastoma Cerebrum

48. Glioblastoma Multiforme Palisading Necrosis

49. Glioblastoma Multiforme Necrosis Palisading

50. Glioblastoma Multiforme Palisading B.V Necrosis

51. Glioblastoma Multiforme Palisading Necrosis

52. Glioblastoma Multiforme

53. A Astrocytoma Low grade B Glioblastoma Multiforme(GBM) C Necrosis with pseudopalisading in GBM.

56. Pilocytic Astrocytoma - children

57. Pilocytic Astrocytoma - children

58. Pilocytic astrocytoma Mural nodule

59. Pilocytic Astrocytoma: Microscopy Palisading pilocytic astrocytes – note plenty of Rosenthal fibres between cells.

61. Medulloblastoma: Primitive neuroectodermal tumor: Children, vermis of cerebellum. Origin Spread

62. Medulloblastoma

63. Medulloblastoma

65. Most common CNS Tumors: Glioblastoma MF

68. Pathology of Increased Intracranial Pressure

74. Uncal Herniation:

78. Cerebral Herniation: Pathogenesis Decerebrate posture Cardiorespiratory failure Death Acute obstruction of CSF pathway Decerebrate posture Cardiorespiratory failure Death Brainstem compression and haemorrhage Foramen magnum Decerebrate posture Cardiorespiratory failure Death Brainstem compression and haemorrhage Upper motor neurone signs Cerebral peduncle compression Occipital infarction Cortical blindness Posterior cerebral artery compression Horizontal diplopia, convergent squint Ipsilateral 6th cranial nerve compression Ipsilateral fixed dilated pupil Ipsilateral 3rd cranial nerve compression Transtentorial Clinical consequence Effect Site of herniation

79. Decorticate posturing, with elbows, wrists and fingers flexed, and legs extended and rotated inward.

80. Look for good in others… no one is without faults and everyone has some good qualities! BK.

99. 50y Female smoker - Headache.

100. 50y Female smoker - Headache.

104. 35y Male, depression Axial T1 weighted MRI Axial T2 weighted MRI

105. 35y Male, depression Coronal T1 weighted MRI Coronal T2 weighted MRI

107. 3y Male, constant cry…. Axial T1 weighted MRI Axial T2 weighted MRI

108. 3y Male, constant cry…. Coronal T1 weighted MRI

111. 65y Fem morning headache.

113. Metastatic Melanoma: multiple

114. Brain Metastases: Surrounding edema.

118. It has been my philosophy of life that difficulties vanish when faced boldly . --Isaac Asimov

119. Other CNS tumors

121. Medulloblastoma

122. Ependymoma-hemorrhage

123. Ependymoma 4 th Ventricle

124. Ependymoma 4 th Ventricle

125. Ependymoma

127. Schwannoma / Neurofibroma

128. Schwannoma 8 th Nerve:

129. Bilateral 8 th nerve schwannomas.

130. Schwannoma:

131. Schwannoma

132. Neurofibromatosis:

133. Neurofibromatosis: Café-au-lait spot

134. Schwannoma

135. Schwannoma

139. Fibrous – spindle cells.

145. Brudzinski Sign of Meningitis:

147. GBM: Glomeruloid bodies:

148. Normal Fundus - Papilledema

149. Normal vs Glaucoma