Volume 30, No. 2/2011(March/April)
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 Clinical Neuropathology
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Editorial
Clinical Neuropathology, Vol. 30 – No. 2/2011
J.A. Hainfellner
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011
J.A. Hainfellner
Original contribution
FISH-based detection of 1p 19q codeletion in oligodendroglial tumors: procedures and protocols for neuropathological practice – a publication under the auspices of the Research Committee of the European Confederation of Neuropathological Societies (
A. Woehrer, P. Sander, C. Haberler, S. Kern, H. Maier, M. Preusser, C. Hartmann, J.M. Kros and J.A. Hainfellner
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011 (47-55)
FISH-based detection of 1p 19q codeletion in oligodendroglial tumors: procedures and protocols for neuropathological practice – a publication under the auspices of the Research Committee of the European Confederation of Neuropathological Societies (
A. Woehrer1,2, P. Sander3, C. Haberler1, S. Kern1, H. Maier3, M. Preusser2,4, C. Hartmann5,6, J.M. Kros7 and J.A. Hainfellner1,2
1Institute of Neurology, 2Comprehensive Cancer Center Central Nervous System Unit (CCC-CNS), Medical University of Vienna, Vienna, 3Department of Pathology, Medical University of Innsbruck, Innsbruck, 4Department of Medicine I, Medical University of Vienna, Vienna, Austria, 5Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-University Heidelberg, 6Clinical Cooperation Unit Neuropathology, German Cancer Research Center, Heidelberg, Germany, and 7Department of Pathology, Erasmus MC Rotterdam, Rotterdam, The Netherlands
The codeletion of chromosomal arms 1p 19q is a characteristic and early genetic event in oligodendroglial tumors, that is associated with a better prognosis and enhanced response to therapy. Over the last years, the increasing clinical demand to determine the 1p 19q status has led to the implementation of its testing in many neuropathology laboratories. Several different methods for 1p 19q testing are available: PCR-based loss of heterozygosity analysis, multiplex ligation-dependent probe amplification, array comparative genomic hybridization, and fluorescence in situ hybridization (FISH). Herein, we focus and critically discuss the latter method because a detailed description of procedures and protocols for FISH-based 1p 19q testing in practice is lacking. We present a practical approach to the FISH-based assessment of the 1p 19q status in oligodendroglial tumors, from commonly used locus-specific probes and technical protocols to the neuropathological interpretation of results. Thereby, we aim to facilitate the implementation of FISH-based 1p 19q testing for clinical purposes in standard neuropathology laboratories without special focus on brain tumor research.Correspondence to:
J.A. Hainfellner
Institute of Neurology, CCC-CNS
Medical University of Vienna
Waehringer Guertel 18–20
1097 Vienna, Austria
Email: johannes.hainfellner@meduniwien.ac.at
Original contribution
Comparison of four neuropathological scales for Alzheimer’s disease
H. Brunnström and E. Englund
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011 (56-69)
Comparison of four neuropathological scales for Alzheimer’s disease
H. Brunnström and E. Englund
Department of Pathology, Lund University and Regional Laboratories Region Skåne, Lund, Sweden
Objective: There are several neuropathological scales for staging of Alzheimer pathology. The system proposed by Braak and Braak is based on the topographic distribution of neurofibrillary tangles and neuropil threads, while that of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) is based on the quantity of neocortical neuritic plaques. A combination of the Braak and CERAD staging scales was recommended by the National Institute on Aging and Reagan Institute (NIA-RI). The Poly-Pathology Alzheimer’s Disease assessment, nine areas (PPAD9) is a staging system based on the extent of neuronal degeneration, microvacuolization, cytoarchitectural disorder and gliosis, in addition to neurofibrillary tangles and neuritic plaques, in nine cerebral regions. The aim of the present study was to critically compare these four neuropathological staging scales. Methods: We assessed the Alzheimer pathology, using the four scales, in 43 patients with various dementia disorders, with focus on concordance and differences between the staging systems. Results: Comparing the staging systems, the Spearman’s rho value for PPAD9 vs. Braak was 0.65, for PPAD9 vs. CERAD 0.72, for PPAD9 vs. NIA-RI 0.67, and for Braak vs. CERAD 0.46. Conclusion: The correlation between the neuropathological staging systems was suboptimal, and we conclude that the choice of staging system affects the evaluation of Alzheimer pathology, and hence the final diagnosis.Correspondence to:
H. Brunnström, MD
Department of Pathology
Regional Laboratories Region Skåne
22185 Lund, Sweden
Email: hans.brunnstrom@med.lu.se
Original contribution
Chordoid meningioma of the third ventricle: a case report and review of the literature
J.L. Wilson, T.L. Ellis and R.T. Mott
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011 (70-74)
Chordoid meningioma of the third ventricle: a case report and review of the literature
J.L. Wilson, T.L. Ellis and R.T. Mott
Wake Forest University School of Medicine, Departments of Neurosurgery and Pathology, Winston-Salem, NC, USA
Chordoid meningioma is a rare variant of meningioma with histologic features that mimic chordoma and other chordoid neoplasms. This tumor is important to recognize, as there is a well-documented propensity for local recurrence and aggressive behavior. Most cases occur around the cerebral convexities, in locations that are similar to classical forms of meningioma. Intraventricular forms of chordoid meningioma are rare, with most reported cases arising in the lateral ventricles. We present a case of a chordoid meningioma that presented in the third ventricle of a 63-year-old female. This represents only the second documented case of a third ventricular chordoid meningioma and the first case in an adult. The distinction from other chordoid neoplasms can be challenging, particularly chordoid gliomas, which classically occur in this location. Herein, we compare and contrast chordoid meningioma with chordoid glioma and provide a review of the relevant literature.Correspondence to:
R.T. Mott, MD
Department of Pathology
Wake Forest University Baptist Medical Center
Medical Center Blvd
Winston-Salem, NC 27157, USA
Email: rmott@wfubmc.edu
Original contribution
Primary intracerebral Hodgkin lymphoma with recurrence
W.-C. Foo, A. Desjardins and T.J. Cummings
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011 (75-79)
Primary intracerebral Hodgkin lymphoma with recurrence
W.-C. Foo1, A. Desjardins2 and T.J. Cummings1
Departments of 1Pathology and 2Neurology, Duke University Medical Center, Durham, NC, USA
Objective: To report a case of primary intracerebral Hodgkin lymphoma with disease recurrence. Methods: Case report and review of the literature. Results: A 58-year-old immunocompetent male presented with aphasia. Neuroimaging revealed a left temporal lobe lesion. A craniotomy and resection were performed, and the diagnosis of classical Hodgkin lymphoma was made. Systemic work-up for lymphoma was negative. Postoperatively, the patient was treated with whole brain irradiation. 14 months later, the patient developed an enhancing lesion in his pons and received combination chemotherapy and radiation therapy. Repeat imaging demonstrated leptomeningeal enhancement and multiple lesions throughout the cerebral hemispheres, cerebellum and brainstem. Comment: We report what appears to be the first case of a patient with aggressive primary intracerebral Hodgkin lymphoma with disease recurrence.Correspondence to:
W.-C. Foo, MD
Duke University Medical Center
Department of Pathology
Box 3712, Durham, NC 27710, USA
Email: foo00001@mc.duke.edu
Original contribution
Central liponeurocytoma: case report and review of literature
K. Gupta, P. Salunke, I. Kalra and R.K. Vasishta
Abstract
Clinical Neuropathology, Vol. 30 – No. 2/2011 (80-85)
Central liponeurocytoma: case report and review of literature
K. Gupta1, P. Salunke2, I. Kalra1 and R.K. Vasishta1
Departments of 1Histopathology and 2Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
The lipomatous differentiation occurring within neurocytoma has more frequently been reported in neurocytoma of cerebellar origin as case reports and short series. This case report describes the clinical, radiological, histopathological and ultrastructural findings of supratentorial central neurocytoma with lipomatous differentiation in a 45-year-old female. Magnetic resonance imaging (MRI) revealed an intraventricular lesion in the right trigone which was isointense on T1 and hyperintense on T2 weighted images. There were small cystic areas and it enhanced brilliantly and homogenously on contrast. The rare lipomatous differentiation occurring in neurocytoma in the supratentorial location lends it a distinct morphological profile and thus recommends its designation as “central liponeurocytoma”.Correspondence to:
Dr. K. Gupta, Assistant Professor
Department of Histopathology, PGIMER
Chandigarh. 160012, India
Email: kirtigupta10@yahoo.co.in
Letter to the Editor
Unusual balloon cell features in melanoma brain metastasis: a potential diagnostic pitfall in surgical neuropathology
M. Gessi, H.-P. Fischer, L. Rösseler, H. Urbach, T. Pietsch and F.K.H. van Landeghem
Abstract
Unusual balloon cell features in melanoma brain metastasis: a potential diagnostic pitfall in surgical neuropathology
M. Gessi, H.-P. Fischer, L. Rösseler, H. Urbach, T. Pietsch and F.K.H. van Landeghem
Institute of 1Neuropathology, 2Pathology, Department of 3Neurosurgery, 4Radiology, University of Bonn Medical Center, Bonn, Germany
Correspondence to:
Dr. M. Gessi
Institute of Neuropathology, University of Bonn Medical Center, Sigmund-Freud-Straße 25, 53127 Bonn, Germany
Email: mgessimd@yahoo.com
Euro-CNS News
Society News of the European Confederation of Neuropathological Societies
