Cerebrum Line Drawings The line drawing of the cerebrum, cerebellum and brainstem illustrate how the differential diagnosis of tumor types changes as associated with the tumor location at different sites of the cranial axis. Compare the types of neoplasms occurring at the same anatomic site in both age groups.	No labels for this image
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Intra/Extramedullary Tumors of Spinal Cord Line drawing of intramedullary and extramedullary tumors of the spinal cord. Note the diffuse infiltrative growth patterns of the astrocytoma, oligod- endroglioma and gliaoblastoma that generally preclude surgical extirpation. The ependymoma and hemangioblastoma tend to be circumscribed and amenable to surgical removal. The extra axial meningioma produces symptomatology primarily by compression of the cord or nerve roots without infiltration of the neural parenchyma. Schwannomas and neurofibromas affect the nerve roots in the extraaxial area.
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Conus Medullaris and Cauda Equina Drawing Line drawing of conus medullaris and cauda equina. Schwannomas are common lesions in the cauda equina. Ependymomas of the cauda equina tend to be restricted to the myxopapillary subtype.	No labels for this image
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Diffuse Expansion of Cerebral Hemisphere Diffuse expansion of right cerebral hemispheric white matter in the centrum semiovale with mild expansion across the corpus callosum and within temporal lobe and internal capsule. Lower grade gliomas generally lack hemorrhage or necrosis.	No labels for this image
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Grade II Diffuse Fibrillary Astrocytoma Grade II diffuse fibrillary astrocytoma showing a mild to moderately hypercellular neoplasm. Note the diffuse fine fibrillary background which is produced by the astrocytic cell processes. Nuclear pleomorphism and anaplasia are not seen. No evidence of endothelial hyperplasia or necrosis is observed in lower grade astrocytic neoplasms.
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Large Expansile Malignant Neoplasm Large expansile malignant neoplasm in the right frontal lobe. The mass effect has causese right cingulate gyrus herniation beneath the falx cerebri; herniation of the right uncus is also illustrated.
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Malignant Astrocytic Neoplasm Malignant astrocytic neoplasms typically are densely hypercellular, show nuclear anaplasia, a markedly increased mitotic activity and endothelial hyperplasia. Although not seen in this photograph, tumor necrosis is common.
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Pontine Glioma Pontine glioma. This image illustrates the diffuse "egg-like" expansion of the pons and lower midbrain that is usual for this neoplasm.	No legend for this image
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MRI Scan of a Hypothalamic Glioma MRI scan of a hypothalamic glioma. Large "cauliflower-like" expansile mass in the suprasellar-hypothalamic region. These tumors typically have a rather sharp delineation from the adjacent non-tumorous neuropil.
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Hypothalamic Glioma The hypothalamic gliomas tend to be pilocytic astrocytomas with little propensity to diffusely infiltrate into adjacent neural structures. In this photograph, infiltration into the left and right branches of the optic chiasm is visible.
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Optic nerve glioma Note the extremely enlarged right and left optic nerves as well as the markedly expanded chiasm. Optic nerve gliomas are usually pilocytic astrocytomas.	PAS (+) Globules
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Pilocytic Astrocytomas Pilocytic astrocytomas are low grade neoplasms composed of bipolar fusiform astrocytic cells displaying coarsely fibrillar processes. Although not noted in this micrograph, Rosenthal's fiber formation is commonly observed in these tumors. These tumors almost uniformly have an extremely low mitotic rate. Generally these tumors are considered to be Grade I lesions.	No legend for this image
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Cerebellar astrocytoma The tumor nodule is clearly evident on the surface of the cerebellum. Examining this image and the compare image one can appreciate the development of a gross cyst within the cerebellar hemisphere.	No legend for this image
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Protrusion of the Cerebellar Tonsils This image shows prominent tongue like protrusion of the cerebellar tonsils. The arrows indicate the position of the foramen magnum. The tonsils have prominently herniated into the foramen magnum.
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Glioblastoma Multiforme This image has been previously used in this series to demonstrate high grade (malignant) astrocytic neoplasms. Glioblastoma typically is hemorrhagic and necrotic. The neoplasm typically diffusely infiltrates in a ragged manner making surgical resection virtually impossible. The rapid growth of these neoplasms is responsible for rapid volume expansion and the compartmental herniation syndromes that often occur.	No legend for this image
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Microscopic Glioblastoma Multiforme The microscopic field shows a prominent serpentine pattern of pseudopalisading of tumor nuclei around a small focus of necrosis. Pseudopalisading necrosis is typical of glioblastoma multiforme. The blood vessels, although not easily appreciated in this magnification also display endothelial proliferative change.	No legend for this image
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Glioblastoma Multiforme Glioblastoma multiforme is one of the most malignant neoplasms of the central nervous system. This image shows metastatic glioblastoma multiforme in the pulmonary tissues.	No legend for this image
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Oligodendroglioma I Oligodendroglioma: Fine stippled calcification in the parietal lobe is barely visible on a plain skull film. These calcifications were noted 20 years prior to the patient's death. CT scanning of the head 2 years before the patient's death shows the presence of a partially calcified lesion in the right parietal lobe. The ventricles are also enlarged.	No legend for this image
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Oligodendroglioma II Oligodendroglioma: Multiple coronal sections of cerebral hemispheres show a large hemorrhagic but relatively circumscribed neoplasm in the right parietal lobe. Note the dense hemosiderin staining in the third and lateral ventricular ependyma indicating prior hemorrhage from the neoplasm.	No legend for this image
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Microscopic Oligodendroglioma Microscopic oligodendroglioma The image shows a relative sea of uniform cells having water cleared cytoplasm surrounding a relatively uniform, although slightly irregular, darkly staining nucleus. The appearance is that of a sea of "fried eggs". Fine plexiform vascular channels also prominently course through the neoplasm. Some areas of myxoid change as seen in the upper right hand corner are occasionally encountered. Calcifications as noted by the arrow are fairly common in oligodendrogliomas.	No legend for this image
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Ependymoma I A fleshy mass of soft tissue approximately the same tinctorial qualities as the caudate nucleusís gray matter is noted attached to the caudate nucleus.	No legend for this image
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Ependymoma II Shows a large variegated, fungating mass in the fourth ventricular region.	No legend for this image
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Ependymoma II Ependymoma The microscopic appearance of an ependymoma is notable for prominent true rosette formation (Flexner-Wintersteiner rosettes). True rosettes are formed when the cells are arranged neatly in a circular fashion forming a central canal. Pseudorosettes are more commonly observed histologically in ependymomas; these demonstrate prominent perivascular aggregations of the tumor cells.	A = Tumor Cell B = Thorotrast
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Medulloblastoma This variegated tumor mass fills the fourth ventricle as well as infiltrates into the cerebellum and brainstem. Medulloblastoma is theorized to arise from germinal rests in the anterior medullary velum. Medulloblastomas in infants and individuals in their first decade of life typically arise in the midline of the cerebellum. Medulloblastomas arising in individuals in their second decade of life (and older) tend to be more lateral, hemispherically, localized.	No legend for this image
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Medulloblastoma Microscopic Medulloblastoma is a primitive neurectodermal tumor having cells displaying extremly high nuclear to cytoplasmic ratios, densely hyperchromatic nuclei that typically tend to mold easily about adjacent tumor cells and the tumor typically forms pseudorosettes of the Homer-Wright type. The mitotic rate in medulloblastomas is extremely high and frequently accompanied by necrosis.	No legend for this image
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Meningioma This parafalcine meningioma is noted to be causing significant compression of the frontal lobe structures. Note there is no apparent infiltration of this neoplasm into the adjacent neural parenchyma.	No legend for this image
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Convexity Meningioma A convexity meningioma attached to the dura is easily reflected showing the charachteristic compression of adjacent cortex and the lack of a propensity to infiltrate the adjacent neuropil.	No legend for this image
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