Difference between revisions of "Medulloblastoma"
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*Classic medulloblastoma (~85% of all medulloblastomas). | *Classic medulloblastoma (~85% of all medulloblastomas). | ||
*Variants of medulloblastoma (~15% of all medulloblastomas together): | *Variants of medulloblastoma (~15% of all medulloblastomas together): | ||
*#Anaplastic | *#Anaplastic / Large cell variant. | ||
*#Desmoplastic/nodular medulloblastoma (DNMB). | *#Desmoplastic/nodular medulloblastoma (DNMB). | ||
*#Medulloblastoma with extensive nodularity (MBEN). | *#Medulloblastoma with extensive nodularity (MBEN). | ||
====Anaplastic variant==== | ====Anaplastic variant==== | ||
| Line 83: | Line 80: | ||
*Severe anaplasia. | *Severe anaplasia. | ||
*Polygonal cells. | *Polygonal cells. | ||
==Prognosis== | |||
*Prognosis based on histology:<ref name=pmid18841049>{{cite journal |author=Gulino A, Arcella A, Giangaspero F |title=Pathological and molecular heterogeneity of medulloblastoma |journal=Curr Opin Oncol |volume=20 |issue=6 |pages=668–75 |year=2008 |month=November |pmid=18841049 |doi=10.1097/CCO.0b013e32831369f4 |url=}}</ref><ref name=pmid20940197>{{cite journal |author=Rutkowski S, von Hoff K, Emser A, ''et al.'' |title=Survival and Prognostic Factors of Early Childhood Medulloblastoma: An International Meta-Analysis |journal=J Clin Oncol |volume=28 |issue=33 |pages=4961–4968 |year=2010 |month=November |pmid=20940197 |doi=10.1200/JCO.2010.30.2299 |url=}}</ref><ref>{{Cite journal | last1 = Rutkowski | first1 = S. | last2 = Bode | first2 = U. | last3 = Deinlein | first3 = F. | last4 = Ottensmeier | first4 = H. | last5 = Warmuth-Metz | first5 = M. | last6 = Soerensen | first6 = N. | last7 = Graf | first7 = N. | last8 = Emser | first8 = A. | last9 = Pietsch | first9 = T. | title = Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. | journal = N Engl J Med | volume = 352 | issue = 10 | pages = 978-86 | month = Mar | year = 2005 | doi = 10.1056/NEJMoa042176 | PMID = 15758008 }} | |||
</ref> DNMB & MBEN > classic > anaplastic variant, large cell variant. | |||
==See also== | ==See also== | ||
Revision as of 14:20, 21 September 2017
Medulloblastoma is a malignant small round cell tumour that is found in the cerebellum.
Morphologically identical supratentorial tumours are called primitive neuroectodermal tumour (PNET).
General
- Mostly paediatric population.
- May be seen as a component of nevoid basal cell carcinoma syndrome (NBCCS).
- Gene: patched (abbreviated PTCH1).[1]
- Commonly spread via cerebrospinal fluid (CSF).[2]
- May be detected in CSF cytopathology specimens.
Gross
- Location: cerebellum - key feature.
- Morphologically identical supratentorial tumours are called primitive neuroectodermal tumour (PNET).
- Supratentorial and spinal metastases from initial tumor possible.
Microscopic
Features:[3]
- Small round cell tumour.
- Homer-Wright rosettes:
- Rosette with a meshwork of fibers (neuropil) at the centre.[4]
IHC
- MAP2 usu. +ve
- Synaptophysin +ve (weak to strong)
- NSE +ve/-ve
- NF +ve/-ve
- Chromogranin +ve/-ve
- GFAP +ve/-ve (mostly along blood vessels)
- Vimentin +ve
- Nestin +ve
- INI1 retained (no loss)
DDx:
Images
Medulloblastoma. (WC/KGH)
Medulloblastoma. (WC/KGH)
Homer-Wright rosettes in a medulloblastoma. (WC/jensflorian)
Cerebellar infiltrative growth. (WC/jensflorian)
Demsomplastic nodular medullloblastoma. (WC/jensflorian)
Anaplastic large cell medulloblastoma. (WC/jensflorian)
Medulloblastoma cells smear. (AFIP)
Medulloblastoma in the cerebellum. (AFIP)
Reticulin stain highlighting "pale islands" in a desmoplastic medulloblastoma (WC/jensflorian)
MIB-1 immunostaining in desmoplastic medulloblastoma (WC/jensflorian)
_in_adult.JPG)
_in_adult.JPG)
Case:
Classic Medulloblastoma of the SHH type. (WC/jensflorian)
Epitheloid ribboning and nuclear moulding of tumor cells. (WC/jensflorian)
Areas of geographic necrosis. (WC/jensflorian)
Partial MAP2 immunoreactivity. (WC/jensflorian)
www:
- Medulloblastoma (ouhsc.edu).
- Medulloblastoma - several images (upmc.edu).
- Medulloblastoma with rhabdomyoblastic differentiation - several images (upmc.edu).
Subtypes
- Classic medulloblastoma (~85% of all medulloblastomas).
- Variants of medulloblastoma (~15% of all medulloblastomas together):
- Anaplastic / Large cell variant.
- Desmoplastic/nodular medulloblastoma (DNMB).
- Medulloblastoma with extensive nodularity (MBEN).
Anaplastic variant
Features:
- Larger cells.
- Severe anaplasia.
- Polygonal cells.
Prognosis
- Prognosis based on histology:[5][6][7] DNMB & MBEN > classic > anaplastic variant, large cell variant.
See also
References
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 601309
- ↑ Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 424 Q34. ISBN 978-1416025887.
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q93-Ans.htm. Accessed on: 26 October 2010.
- ↑ Wippold FJ, Perry A (March 2006). "Neuropathology for the neuroradiologist: rosettes and pseudorosettes". AJNR Am J Neuroradiol 27 (3): 488–92. PMID 16551982.
- ↑ Gulino A, Arcella A, Giangaspero F (November 2008). "Pathological and molecular heterogeneity of medulloblastoma". Curr Opin Oncol 20 (6): 668–75. doi:10.1097/CCO.0b013e32831369f4. PMID 18841049.
- ↑ Rutkowski S, von Hoff K, Emser A, et al. (November 2010). "Survival and Prognostic Factors of Early Childhood Medulloblastoma: An International Meta-Analysis". J Clin Oncol 28 (33): 4961–4968. doi:10.1200/JCO.2010.30.2299. PMID 20940197.
- ↑ Rutkowski, S.; Bode, U.; Deinlein, F.; Ottensmeier, H.; Warmuth-Metz, M.; Soerensen, N.; Graf, N.; Emser, A. et al. (Mar 2005). "Treatment of early childhood medulloblastoma by postoperative chemotherapy alone.". N Engl J Med 352 (10): 978-86. doi:10.1056/NEJMoa042176. PMID 15758008.