Approach to diagnosis
Reviewer: Eman Abdelzaher, M.D., Ph.D. (see Reviewers page)
Revised: 18 April 2013, last major update February 2012
Copyright: (c) 2005-2013, PathologyOutlines.com, Inc.
Factors to consider:
- Neoplasm: yes or no?
- Yes - hypercellular, composed of atypical fibrillar cells
- No - may be infectious, inflammatory, toxic-metabolic, traumatic, vascular, development or degenerative
- Primary or metastatic neoplasm?
- Glial, neuronal and other primary tumor considerations
- Correlate pathologic diagnosis with age, sex, location and imaging characteristics
- Multiple lesions are often metastases, melanoma, medulloblastoma (late) or lymphoma
Differential diagnosis (adopted from Sternberg)
- Fibrillar cells: fibrosis, granuloma; astroblastoma, astrocytoma, central neurocytoma, ependymoma, fibroblastic meningioma, ganglion cell tumor, glioblastoma, gliosarcoma, hemangioblastoma, Langerhans cell histiocytosis, melanoma, MFH, neurofibroma, pineocytoma, polar spongioblastoma, schwannoma
- Epithelioid cells: xanthogranuloma or gitter cells; chordoma, choroid plexus tumor, craniopharyngioma, embryonal carcinoma, endodermal sinus tumor, hemangioblastoma, medulloepithelioma, melanoma, meningioma, metastatic carcinoma, oligodendroglioma, paraganglioma, pituitary adenoma
- Conspicuously different cells: choriocarcinoma, desmoplastic carcinoma, desmoplastic medulloblastoma, ependymoma, ganglion cell tumor, germinoma, glioblastoma or gliosarcoma with epithelial metaplasia, melanoma, oligoastrocytoma, teratoma, transitional meningioma
End of CNS tumor > CNS tumors > Approach to diagnosis
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