Intracerebral metastases pathophysiology: Difference between revisions
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===Immunohistochemistry=== | ===Immunohistochemistry=== | ||
The immunohistochemistry profile of intracerebral metastases may vary with the type of the primary tumor. Intracerebral metastases are demonstrated by positivity to tumor markers such as:<ref name=IHCprofileofbrainmets1>IHC features of brain metastasis. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015</ref> | *The immunohistochemistry profile of intracerebral metastases may vary with the type of the primary tumor. | ||
*General brain metastases: Pankeratin +ve, [[GFAP]] -ve | *Intracerebral metastases are demonstrated by positivity to tumor markers such as:<ref name=IHCprofileofbrainmets1>IHC features of brain metastasis. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015</ref> | ||
*[[Adenocarcinoma of the lung|Lung adenocarcinoma]] and [[small cell lung carcinoma]]: [[TTF1 (gene)|TTF-1]] +ve, [[Type II keratin|CK7]] +ve, [[Type I keratin|CK20]] -ve | :*General brain metastases: Pankeratin +ve, [[GFAP]] -ve | ||
*[[Breast carcinoma]]: [[Type II keratin|CK7]] +ve, [[ER]] +ve, [[PR]] +ve, [[Prolactin-induced protein|BRST2]] +ve/-ve | :*[[Adenocarcinoma of the lung|Lung adenocarcinoma]] and [[small cell lung carcinoma]]: [[TTF1 (gene)|TTF-1]] +ve, [[Type II keratin|CK7]] +ve, [[Type I keratin|CK20]] -ve | ||
*[[Colorectal carcinoma]]: [[Type I keratin|CK20]] +ve, [[Cdx2|CDX2]] +ve, [[TTF1 (gene)|TTF-1]] -ve, [[Type II keratin|CK7]] -ve | :*[[Breast carcinoma]]: [[Type II keratin|CK7]] +ve, [[ER]] +ve, [[PR]] +ve, [[Prolactin-induced protein|BRST2]] +ve/-ve | ||
*[[Renal cell carcinoma|Clear cell renal cell carcinoma]]: [[PAX8]] +ve, [[vimentin]] +ve, [[CD10]] +ve, [[Type II keratin|CK7]] -ve, [[Type I keratin|CK20]] -ve | :*[[Colorectal carcinoma]]: [[Type I keratin|CK20]] +ve, [[Cdx2|CDX2]] +ve, [[TTF1 (gene)|TTF-1]] -ve, [[Type II keratin|CK7]] -ve | ||
*[[Melanoma]]: [[S-100 protein|S-100]] +ve, [[HMB-45]] +ve, [[MART-1|Melan-A]] +ve. | :*[[Renal cell carcinoma|Clear cell renal cell carcinoma]]: [[PAX8]] +ve, [[vimentin]] +ve, [[CD10]] +ve, [[Type II keratin|CK7]] -ve, [[Type I keratin|CK20]] -ve | ||
:*[[Melanoma]]: [[S-100 protein|S-100]] +ve, [[HMB-45]] +ve, [[MART-1|Melan-A]] +ve. | |||
==References== | ==References== | ||
Revision as of 18:19, 10 November 2015
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Intracerebral metastases Microchapters |
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Differentiating Intracerebral Metastases from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Intracerebral metastases pathophysiology On the Web |
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American Roentgen Ray Society Images of Intracerebral metastases pathophysiology |
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Risk calculators and risk factors for Intracerebral metastases pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Pathophysiology
Pathogenesis
Gross Pathology
- Typically metastases are sharply demarcated from the surrounding parenchyme and usually there is a zone of peritumoral edema out of proportion with the tumor size.
- Common intracranial sites associated with subependymal giant cell astrocytoma include:[1]
- Cerebrum (80%)
- Cerebellum (15%)
- Brain stem (5% )
Gallery
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![This solitary brain metastasis from thyroid papillary carcinoma resulted in neurological symptoms. The thyroid primary was clinically occult. (Courtesy of Dr. Nikola Kostich, Minneapolis, MN.).[2]](/images/1/12/THYROID_PAPILLARY_CARCINOMA_METASTATIC_TO_BRAIN.jpg)
This solitary brain metastasis from thyroid papillary carcinoma resulted in neurological symptoms. The thyroid primary was clinically occult. (Courtesy of Dr. Nikola Kostich, Minneapolis, MN.).[2]
![This solitary brain metastasis from thyroid papillary carcinoma resulted in neurological symptoms. The thyroid primary was clinically occult. (Courtesy of Dr. Nikola Kostich, Minneapolis, MN.).[2]](/index.php/File:THYROID_PAPILLARY_CARCINOMA_METASTATIC_TO_BRAIN.jpg)
Microscopic Pathology
The histopathological appearance of intracerebral metastases may vary with the type of primary tumor. Common findings are listed below:[3][4]
- Tubule formation/glands
- Well-circumscribed and sharply demarcated from surrounding tissue (with the exception of melanoma metastasis)
- Mitoses
- Nuclear atypia
- Nuclear hyperchromasia
- Variation of nuclear size
- Variation of nuclear shape
Gallery
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![Very low magnification micrograph demonstrating metastatic adenocarcinoma that from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum seen on the image has Bergmann gliosis and Purkinje cell loss.[5]](/images/a/ae/Metastatic_adenocarcinoma_-_cerebellum_-_very_low_mag.jpg)
Very low magnification micrograph demonstrating metastatic adenocarcinoma that from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum seen on the image has Bergmann gliosis and Purkinje cell loss.[5]
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![High magnification micrograph demonstrating metastatic adenocarcinoma that is from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum has Bergmann gliosis and Purkinje cell loss.[5]](/images/0/06/Metastatic_adenocarcinoma_-_cerebellum_-_high_mag.jpg)
High magnification micrograph demonstrating metastatic adenocarcinoma that is from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum has Bergmann gliosis and Purkinje cell loss.[5]
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![High magnification micrograph of a brain metastasis on HPS stain demonstrating normal brain tissue on the left and tumor cells on the right. The sharp demarcation between tumor and normal is typical of brain metastases.[5]](/images/9/9f/Brain_metastasis_-_high_mag.jpg)
High magnification micrograph of a brain metastasis on HPS stain demonstrating normal brain tissue on the left and tumor cells on the right. The sharp demarcation between tumor and normal is typical of brain metastases.[5]
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![Adenocarcinoma infiltrating the brain in a case of lung cancer on H&E stain.[5]](/images/a/a4/Brain_metastasis_-_high_mag_2.jpg)
Adenocarcinoma infiltrating the brain in a case of lung cancer on H&E stain.[5]
![Very low magnification micrograph demonstrating metastatic adenocarcinoma that from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum seen on the image has Bergmann gliosis and Purkinje cell loss.[5]](/index.php/File:Metastatic_adenocarcinoma_-_cerebellum_-_very_low_mag.jpg)
![High magnification micrograph demonstrating metastatic adenocarcinoma that is from a colorectal primary, i.e. colorectal carcinoma, by immunostains on HPS stain. The cerebellum has Bergmann gliosis and Purkinje cell loss.[5]](/index.php/File:Metastatic_adenocarcinoma_-_cerebellum_-_high_mag.jpg)
![High magnification micrograph of a brain metastasis on HPS stain demonstrating normal brain tissue on the left and tumor cells on the right. The sharp demarcation between tumor and normal is typical of brain metastases.[5]](/index.php/File:Brain_metastasis_-_high_mag.jpg)
![Adenocarcinoma infiltrating the brain in a case of lung cancer on H&E stain.[5]](/index.php/File:Brain_metastasis_-_high_mag_2.jpg)
Immunohistochemistry
- The immunohistochemistry profile of intracerebral metastases may vary with the type of the primary tumor.
- Intracerebral metastases are demonstrated by positivity to tumor markers such as:[6]
- General brain metastases: Pankeratin +ve, GFAP -ve
- Lung adenocarcinoma and small cell lung carcinoma: TTF-1 +ve, CK7 +ve, CK20 -ve
- Breast carcinoma: CK7 +ve, ER +ve, PR +ve, BRST2 +ve/-ve
- Colorectal carcinoma: CK20 +ve, CDX2 +ve, TTF-1 -ve, CK7 -ve
- Clear cell renal cell carcinoma: PAX8 +ve, vimentin +ve, CD10 +ve, CK7 -ve, CK20 -ve
- Melanoma: S-100 +ve, HMB-45 +ve, Melan-A +ve.
References
- ↑ Khuntia, Deepak (2015). "Contemporary Review of the Management of Brain Metastasis with Radiation". Advances in Neuroscience. 2015: 1–13. doi:10.1155/2015/372856. ISSN 2356-6787.
- ↑ Gross image of brain metastases. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015
- ↑ Microscopic features of brain metastasis. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015
- ↑ Microscopic appearance of brain metastases. Dr Bruno Di Muzio and Dr Trent Orton et al. Radiopaedia 2015. http://radiopaedia.org/articles/brain-metastases. Accessed on November 10, 2015
- ↑ 5.0 5.1 5.2 5.3 Microscopic images of brain metastasis. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015
- ↑ IHC features of brain metastasis. Libre pathology 2015. http://librepathology.org/wiki/index.php/Brain_metastasis. Accessed on November 10, 2015