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2015 Annual Meeting
Evening Specialty Conference - Neuropathology
Tuesday, March 24, 2015 - 7:30pm to 9:30pm
CC 302
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Case title: A 54-year-old man with a T2-hyperintense frontal lobe lesion
Clinical Summary:

Approximately 6 months prior to seeking medical attention, a 54-year-old right-handed man began experiencing recurrent episodes of smelling foul odors. These foul smell sensations were noted more frequently over time and occured with headaches of increasing severity. There was no history of a loss of consciousness or more generalized seizures. Eventually, an MRI was performed that demonstrated a 3 cm, T2-hyperintense, modestly expansile lesion in the left frontal lobe. No enhancement was noted following the administration of contrast material. The patient underwent neurosurgical resection of the lesion. 











Case title: Benign peripheral nerve sheath tumor.
Clinical Summary:

CASE HISTORY: A 64 year old woman presented with slowly progressive painful mass in left foot. On examination skin fold freckling was present in the right torso (front and back) stopping at midline. The patient’s clinical history includes a previous surgery for resection of a mass from the left ankle diagnosed as schwannoma (2013). In addition, 2 raised dermal lesions were biopsied and diagnosed as dermal nevi. .There is no family history of neurofibromatosis. 

Clinical Summary:

A 38-year-old man presented with left facial numbness. MR imaging revealed a contrast-enhancing dura-based mass of the left middle cranial fossa. Subsequent craniotomy with gross total resection of the mass was performed.

Figure 1. Sagittal T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 1. Sagittal T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 2. Axial T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 2. Axial T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 3. Coronal T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 3. Coronal T1-weighted MR image with contrast. A highly vascular extra-axial, circumscribed, contrast-enhancing mass is seen in the left middle temporal fossa.
Figure 4. H&E
Figure 4. H&E
Figure 5. H&E.
Figure 5. H&E.
Figure 6. H&E.
Figure 6. H&E.
Figure 7. H&E.
Figure 7. H&E.
Figure 8. H&E.
Figure 8. H&E.
Figure 9. H&E.
Figure 9. H&E.
Figure 10. Phosphohistone-H3.
Figure 10. Phosphohistone-H3.
Figure 11. Phophohistone-H3.
Figure 11. Phophohistone-H3.
Figure 12. Phosphohistone-H3.
Figure 12. Phosphohistone-H3.
Figure 13. Ki-67 antigen (MIB1).
Figure 13. Ki-67 antigen (MIB1).
Figure 14. Ki-67 antigen (MIB1).
Figure 14. Ki-67 antigen (MIB1).
Figure 15. Immunostain 1. Low-power.
Figure 15. Immunostain 1. Low-power.
Figure 16. Immunostain 1. High power.
Figure 16. Immunostain 1. High power.
Figure 17. Immunostain 2. Low power.
Figure 17. Immunostain 2. Low power.
Figure 18. Immunostain 2. Higher power.
Figure 18. Immunostain 2. Higher power.
Figure 19. Immunostain 2. Focal area of tumor. Low power
Figure 19. Immunostain 2. Focal area of tumor. Low power
Figure 20. Immunostain 2. Higher power.
Figure 20. Immunostain 2. Higher power.
Figure 21. Pertinent negative immunostains.
Figure 21. Pertinent negative immunostains.
Figure 22. Immunostain 3. Low power.
Figure 22. Immunostain 3. Low power.
Figure 23. Immunostain 3.
Figure 23. Immunostain 3.
Figure 24. Immunostain 3.
Figure 24. Immunostain 3.
Case title: A defiant 9-year-old girl
Clinical Summary:

A 9-year-old girl presents with progressive symptoms over 10 months

  • Seeing lights coming of nowhere and at times monsters nearby
  • Behavioral changes: defiant (unaware of it)
  • Few episodes of imbalance and ataxia
  • Staring spells (2-3 minutes) a few times per day
  • 2-3 episodes of urine incontinence
H&E LP
H&E LP
H&E HP
H&E HP
H&E HP
H&E HP
H&E HP
H&E HP
H&E HP
H&E HP
GFAP
GFAP
S100
S100

ki67
ki67
IHC Unknown
IHC Unknown
Case title: CASE 5 OLDER WOMAN WITH pontine nodular lesions
Clinical Summary:

67-year-old female found to have a pontine mass of unclear etiology in 2011
Mass stable over several years
Originally had diplopia which improved with prism glasses
later developed ataxia and dysarthria; no pseudobulbar symptoms
lumbar puncture pressures and cerebrospinal fluid analysis normal
Brain biopsy of pons undertaken

Pontine lesion pre biopsy, T1 MRI
Pontine lesion pre biopsy, T1 MRI
Pontine lesion pre biopsy, T1 MRI
Pontine lesion pre biopsy, T1 MRI
Brain Biopsy
Brain Biopsy
Brain Biopsy
Brain Biopsy
Brain Biopsy, CD68
Brain Biopsy, CD68
Brain Biopsy, CD1A
Brain Biopsy, CD1A
Brain Biopsy, S100
Brain Biopsy, S100