Normal Nissl stained neuron

Name: Normal Nissl stained neuron
Uploaded: 2017-07-31T03:21:41+00:00
Duration: PTM21S1
Channel: Bruno Hoover
Description: Normal Nissl stained neuron

Normal Nissl stained neuron
Normal Nissl stained neuron 4/28/2017 Neuron injury; neuroglia; BBB

CELLULAR CHANGES SEEN IN NECROSIS AND APOPTOSIS
TUNEL of hippocampal pyramidal neurons 72 h following permanent MCA occlusion with two cells demonstrating apoptotic bodies, with discrete balls of stained DNA, adjacent to many more stained cells that demonstrate varying degrees of chromatin condensation This picture shows features of hypoxic/ischemic changes of neurons. The neurons have smudged and pyknotic nuclei, collapsed and flame-shaped eosinophilic cytoplasm with accentuated (artificial) pericellular space. Neurons most susceptible to hypoxia are in the hippocampus (Sommer’s sector) and the cerebellum (Purkinje cells). 4/28/2017 Neuron injury; neuroglia; BBB

Neuron injury; neuroglia; BBB
Normal Central chromatolysis 4/28/2017 Neuron injury; neuroglia; BBB

NEURONOPHAGIA Phagocytosis of damaged neurons Microglia and monocytes
Associated with rapid cell death: often seen with viral infections 4/28/2017

NEUROFIBRILLARY TANGLE
Twisted filaments in perikaryon Silver + Tau protein + Ubiquitin + Beta-amyloid protein + Neurons of cerebral cortex Seen in: old age Alzheimer’s disease H&E Silver 4/28/2017 Silver

Introduction to neuropathology
Alzheimer's disease, neurofibrillary tangle. The tangles are best demonstrated with Bielschowsky silver stain as shown here, microscopic. 4/28/2017 Introduction to neuropathology

GRANULOVACUOLAR DEGENERATION
Silver Multiple vesicles w/ dense cores Silver + Typical of Alzheimer’s disease Variable numbers seen in old age H&E 4/28/2017 Introduction to neuropathology

Granulovacuolar degeneration seen in AD
4/28/2017 Introduction to neuropathology

LEWY BODY H&E Inclusion with eosinophilic laminated core and halo Single or multiple Ubiquitin + Substantia nigra, locus ceruleus, other areas Seen in: Parkinson’s disease Lewy body dementia 4/28/2017 Introduction to neuropathology

HIRANO BODY dense, hyaline mass actin hippocampus Alzheimer’s disease H&E 4/28/2017 Introduction to neuropathology

PICK BODY H&E Ubiquitin Balloon cell neurons / globose cells Ovoid body, silver + Neurofilaments and microtubules; ubiquitin Pick’s disease 4/28/2017 Introduction to neuropathology

Diffuse axonal injury / axonal spheroids Axons vulnerable to mechanical disruption Acceleration/deceleration; young infants Spheroids filled with accumulated organelles resulting from continued axonal transport in damaged neurons H&E Silver 4/28/2017 Neuron injury; neuroglia; BBB

WALLERIAN DEGENERATION. (a) Descending degeneration below the level of the lesion. There is degenerating myelin (dark area) in the lateral white columns. (b) Ascending degeneration above the lesion (the dorsal columns) [Stained for degenerating myelin – Fink-Heimer stain] 4/28/2017 Neuron injury; neuroglia; BBB

Transverse section of the pons of a patient with multiple sclerosis. (A) Myelin stain showing plaques of demyelination (light areas). 4/28/2017 Neuron injury; neuroglia; BBB

PTAH GFAP Astrocytes 4/28/2017 Neuron injury; neuroglia; BBB

GLIOSIS (ASTROCYTOSIS)
Response to injury Astrocytes: hypertrophy and hyperplasia secondary to CNS damage within 48 hours of injury Glial fibrillary proteins produced Stimulus: soluble factors from neurons and myelin GFAP 4/28/2017 Neuron injury; neuroglia; BBB

OLIGODENDROCYTES Myelinate CNS Injury results in demyelination Viruses, immunologic mechanisms, aging Leukodystrophies H&E 4/28/2017 Neuron injury; neuroglia; BBB

MICROGLIA Resident macrophages ontologically related to cells of the mononuclear phagocyte lineage Resting vs. activated Infarcts, demyelinating processes, infection, injury 4/28/2017 Neuron injury; neuroglia; BBB

Silver Silver Response to noxious stimulus rod cells 4/28/2017 Neuron injury; neuroglia; BBB

Brain tissue destroyed: they act as phagocytes; become filled with breakdown products of myelin = lipid phagocyte H&E 4/28/2017 Neuron injury; neuroglia; BBB

Ependymal cells 4/28/2017 Neuron injury; neuroglia; BBB

This picture in axial (transverse) view shows a Grade III Astrocytoma in the right frontal lobe several years after surgery. The frontal tip was resected at surgery. Note how the tumor has infiltrated posteriorly into the basal ganglia. Astrocytomas infiltrate along white matter tracts and they infiltrate gray matter structures. 4/28/2017 Neuron injury; neuroglia; BBB

This picture of a glioblastoma shows a more infiltrative tumor grossly. Note how the tumor crosses the midline in the corpus callosum. 4/28/2017 Neuron injury; neuroglia; BBB

Pseudopalisading necrosis in a glioblastoma characterized by a garlandlike arrangement of hypercellular tumor nuclei (arrows) lining up around irregular foci of tumor necrosis (n) containing pyknotic nuclei (arrowheads). Note tumor vessel (v) (H&E; original magnification x200). 4/28/2017 Neuron injury; neuroglia; BBB

This is an example of a frontal lobe oligodendroglioma. This 65 year old man presented with a personality change and then had a seizure. Note the thickened corpus callosum and the diffuse involvement of the basal ganglia on the right. These can be well differentiated slow growing tumors. 4/28/2017 Neuron injury; neuroglia; BBB

Oligodendroglioma is a slow growing
Oligodendroglioma: artifactual clearing of tumor cell cytoplasm results in the “fried-egg” appearance. Delicate branching blood vessels traverse the tumor.glial tumor arising from oligodendrocytes of the white matter. A predominant proportion of these tumors involve the frontal lobe. Frequently, there is a long history of poorly controlled seizures. These tumors are composed of uniform round cells with a characteristic delicate capillary vasculature; and microcalcifications (calcospherites) are common. On occasion these can be visualized radiographically and appear as grains of sand scattered randomly throughout the lesion. Formalin fixation of the tumor produces an artifactual perinuclear halo, give the so-called “fried-egg” appearance to the cells of the oligodendroglioma. Although this tumor is infiltrative, its slow growth permits survival for 5-10 years. 4/28/2017 CNS neoplasms

This is a large right lateral ventricular ependymoma which had been operated upon some months before death. Note the surgical scar superiorly. This was an adult who presented with headaches. This is a well circumscribed mass and with modern neurosurgical techniques could be removed. 4/28/2017 Neuron injury; neuroglia; BBB

This is a horizontal section demonstrating the fourth ventricular ependymoma in the 15 month old boy. Although these tumors are histologically well differentiated, the young children present with large tumors and total resection may not be possible. In general, the infants with these large tumors do not do well. This tumor had caused hydrocephalus. Note the enlarged third ventricle. 4/28/2017 Neuron injury; neuroglia; BBB

Ependymoma •A high power view of a pseudorosettes in an ependymoma
Ependymoma •A high power view of a pseudorosettes in an ependymoma. •The neoplastic cells palisade around a capillary (arrow). •These tumors can also form true rosette, that is palisading of nuclei about an empty space with a membrane bounding the lumen. General Microscopic Description •Microscopically the ependymoma looks like an inverted neural tube. •It forms rosettes - a circle of cells about an imaginary space or pseudorosettes -a circle of cells sending processes down to a capillary. •Between rosettes and pseudorosettes are cells with oval pale nuclei and indistinct cytoplasmic borders. •The cells look much like normal ependymal cell with uniform nuclei and epithelial like cytoplasm. 4/28/2017 CNS neoplasms

Medulloblastoma: Note the large gray mass occupying much of the vermis of the cerebellum. This is a medulloblastoma which is a tumor of children, is very fast growing and very malignant. Fortunately, the tumor is also radiosensitive. Medulloblastoma is a tumor of the cerebellum and arises from cells originating in the external granule layer. It is the most common intracranial neuroblastic (primitive) tumor. This tumor occurs predominantly in the pediatric population and accounts for 25 percent of childhood intracranial tumors. Histologically medulloblastoma consists of sheets of closely packed, often slightly elongated, cells with a scanty cytoplasm. The classic feature is the presence of neuroblastic rosettes, but they may not be present in every medulloblastoma. Frequently the tumor arises in the midline and will fill the fourth ventricle, rapidly producing hydrocephalus. Children with medulloblastoma can present with hydrocephalus or cerebellar dysfunction. Although this tumor is highly sensitive to ionizing radiation, it has a propensity to spread within the subarachnoid space as a continuous or discontinuous sheet of tumor. A five year survival rate of 50-75% is possible with total 4/28/2017 Neuron injury; neuroglia; BBB

Here is the microscopic appearance of a medulloblastoma with small round blue cells.
Medulloblastoma is a tumor of the cerebellum and arises from cells originating in the external granule layer. It is the most common intracranial neuroblastic (primitive) tumor. This tumor occurs predominantly in the pediatric population and accounts for 25 percent of childhood intracranial tumors. Histologically medulloblastoma consists of sheets of closely packed, often slightly elongated, cells with a scanty cytoplasm. The classic feature is the presence of neuroblastic rosettes, but they may not be present in every medulloblastoma. Frequently the tumor arises in the midline and will fill the fourth ventricle, rapidly producing hydrocephalus. Children with medulloblastoma can present with hydrocephalus or cerebellar dysfunction. Although this tumor is highly sensitive to ionizing radiation, it has a propensity to spread within the subarachnoid space as a continuous or discontinuous sheet of tumor. A five year survival rate of 50-75% is possible with total 4/28/2017 CNS neoplasms

Primary central nervous system lymphoma is an extranodal lymphoma that, as the name implies, occurs primarily in the CNS. The frequency of this cancer has increased worldwide primarily due to the AIDS epidemic. More typically, the sporadic or non-AIDS form of primary CNS lymphoma is seen in elderly individuals and in immunosuppression states. Most CNS lymphomas are non-Hodgkin’s lymphomas of B cell origin and appear as ill-defined masses involving diffuse infiltration of white matter, cortex, and deep gray structures. They have a predilection for periventricular spread. Perivascular cuffing by malignant lymphocytes with expansion of the vascular wall can best be appreciated with a reticulin stain which demonstrates a “chicken-wire” pattern. The Epstein-Barr virus genome is present in most tumors in immunocompromised patients. Most CNS lymphomas show a dramatic initial response to steroid therapy with pronounced shrinkage of the tumor on MRI scans. Unfortunately, this response is only temporary and recurrence is the rule. 4/28/2017 CNS neoplasms

Meningioma •A coronal section of the brain through the brain at the level of the lenticular nuclei. •A large mass between the hemispheres markedly distorts the brain. •The mass is separable from the brain parenchyma. •This is characteristic of a meningioma, which arises from the arachnoid cells. •It is the only truly benign tumor of the CNS. Meningioma is a common tumor, the majority arising from arachnoidal cells. Many arise in the arachnoid granulations. Meningiomas, depending on their location (i.e., the falx, the sphenoid ridge, the olfactory groove, the foramen magnum, and over the hemispheric convexities), will differ in clinical presentations related to functional deficits induced at these specific sites. In general, meningiomas occur more commonly in females with a female-male ratio of 3:2 for intracranial tumors and 10:1 for spinal meningiomas. Grossly, meningiomas are usually firm or rubbery, well-demarcated, round and occasionally lobulated masses. The histologic hallmark is a whorled pattern of meningothelial cells in association with psammoma bodies (laminated, spherical calcospherites). The superficial position of meningiomas, coupled with the neural displacement rather than infiltration, invites total surgical excision. Occasionally meningiomas are frankly malignant and they metastasize outside the central nervous system, for example to the lung. This is usually attributed to invasion of a venous dural sinus by the tumor, or to the shedding of the tumor cells at the time of excision. 4/28/2017 Neuron injury; neuroglia; BBB

Note how this meningioma beneath the dura has compressed the underlying cerebral hemisphere. Rarely, meningiomas can be more aggressive and invade. Meningioma is a common tumor, the majority arising from arachnoidal cells. Many arise in the arachnoid granulations. Meningiomas, depending on their location (i.e., the falx, the sphenoid ridge, the olfactory groove, the foramen magnum, and over the hemispheric convexities), will differ in clinical presentations related to functional deficits induced at these specific sites. In general, meningiomas occur more commonly in females with a female-male ratio of 3:2 for intracranial tumors and 10:1 for spinal meningiomas. Grossly, meningiomas are usually firm or rubbery, well-demarcated, round and occasionally lobulated masses. The histologic hallmark is a whorled pattern of meningothelial cells in association with psammoma bodies (laminated, spherical calcospherites). The superficial position of meningiomas, coupled with the neural displacement rather than infiltration, invites total surgical excision. Occasionally meningiomas are frankly malignant and they metastasize outside the central nervous system, for example to the lung. This is usually attributed to invasion of a venous dural sinus by the tumor, or to the shedding of the tumor cells at the time of excision. 4/28/2017 Neuron injury; neuroglia; BBB

Normal Nissl stained neuron

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