Neuropathology: High-Yield Pathology

Parasitic Infections

Cerebral Toxoplasmosis Definition CNS infection with Toxoplasma gondii , a ubiquitous obligate intracellular protozoan that parasitizes humans and animals Clinical Features Epidemiology Worldwide distribution with increased incidence in France, Central and South America Definitive hosts: cats 225,000 cases/year in United…

Mycoses

Cerebral Cryptococcosis Definition Severe CNS fungal infections caused by the genus Cryptococcus ; includes meningitis and focal “cryptococcomas” Clinical Features Epidemiology C. neoformans : ubiquitous in soil, bird excrement, compost C. gattii : tropical/subtropical climates, North American western coast Eucalyptus…

Bacterial Infections

Acute Purulent Meningitis Definition An acute inflammatory process involving leptomeninges and cerebrospinal fluid Clinical Features Epidemiology Approximately 2.5/100,000 (United States) each year Hematogenous spread most common Pneumonia with bacteremia Other routes Direct inoculation (trauma, procedures) Invasion (sinusitis, mastoiditis, oral infections)…

Tumors of the Skull Base

Chordoma of Skull Base Definition Slow-growing, locally aggressive bone tumor; believed to originate from embryonic notochord rests (“ecchordosis physaliphora”), found incidentally in 1% to 2% of autopsies Clinical Features Epidemiology Rare tumor: 0.2% of all intracranial tumors; 3% to 4%…

Metastatic Brain Tumors

Definition Hematogenous spread of a primary tumor originating outside the CNS to the brain or its coverings Clinical Features Epidemiology Most common brain tumors in adults Incidence of about 10 to 30 per 100,000 per year CNS metastases found in…

Central Nervous System Cysts

Definition Benign developmental thin-walled cysts defined by type of epithelium and location Examples: epidermoid, dermoid, colloid, arachnoid, endodermal, and ependymal Clinical Features Epidemiology Constitute about 1% of intracranial masses Affect all ages No gender predominance Believed to result from developmental…

Primary Melanocytic Tumors of the Central Nervous System

Definition Primary tumors of the brain and spinal cord arising from arachnoidal/pial melanocytic cells Melanocytoma: localized, low-grade, noninvasive Melanoma: malignant, invasive, mitotically active Clinical Features Epidemiology Very rare entities Wide age range, but most occur in the fifth decade You’re…

Sellar and Suprasellar Tumors

Pituitary Adenomas Definition A neoplasm of the adenohypophysis Most common tumor of the pituitary gland Clinical Features Epidemiology 10% to 15% of all intracranial tumors Annual incidence: 0.2 to 2.8 cases per 100,000 About 20% to 30% of pituitary adenomas…

Hemangioblastoma

Definition Highly vascularized tumor composed of stromal cells and capillaries usually found in the cerebellum, brain stem, or spinal cord Clinical Features Epidemiology 1% to 2% of all intracranial tumors Most common in adults in third to fifth decades; can…

Germ Cell Tumors of the Central Nervous System

Germinoma Definition Radiosensitive neoplasm of young individuals arising in the pineal or suprasellar region with histopathologic and immunohistochemical features similar to testicular seminoma and ovarian dysgerminoma Clinical Features Epidemiology Germinomas account for about 3% of pediatric intracranial tumors 65% of…