Intra-Operative Neuropathology for the Non-Neuropathologist by Cynthia T. Welsh

Author:Cynthia T. Welsh
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Differential Diagnosis: DNET

Dysembryoplastic neuroepithelial tumor (DNET) is another tumor with ganglion cells which is typically seen in young people with seizures, and affects cortex. Multiple cortical nodules of oligodendroglial-like cells and glial processes surrounding microcysts with “floating” neurons (Fig. 3H.10) define DNET. These tumors may be completely removed.

Fig. 3H.10Histology – DNET – microcysts containing neurons

Differential Diagnosis: SEGA

Large cells, some of which have neuronal characteristics (Fig. 3H.11) admixed with large gemistocytic appearing astrocytes are seen in subependymal giant cell astrocytoma (SEGA). Knowing the tissue is intra/periventricular in a patient with tuberous sclerosis (TS) goes a long way toward entering into the correct differential. Recognizing the neuronal flavor to some of these cells and calling this tumor a ganglioglioma would not actually be as problematic as calling it a gemistocytic astrocytoma (which has very negative connotations in respect to grade and prognosis).

Fig. 3H.11Histology – SEGA – large cells some with eosinophilic cytoplasm, others with what appears to be peripheral Nissl substance

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