Craniopharyngioma classification: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Marjan Khan (talk | contribs)
1,497 edits
No edit summary
Marjan Khan (talk | contribs)
1,497 edits
No edit summary
Line 3: Line 3:
{{CMG}}{{AE}}{{Marjan}}
{{CMG}}{{AE}}{{Marjan}}
==Overview==
==Overview==
There are two subtypes of craniopharyngioma based on the histological and imaging features: Adamantinomatous and papillary.
There are two subtypes of craniopharyngioma based on the [[Histology|histological]] and [[Imaging|imaging features]]: Adamantinomatous and papillary.


==Classification==
==Classification==
* Craniopharyngiomas are believed to derive from Rathke cleft rather than [[squamous cell]] rests. <ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>
* Craniopharyngiomas are believed to derive from [[Rathke's pouch|Rathke cleft]] rather than [[squamous cell]] rests. <ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>


* Craniopharyngiomas are classified according to their histologic appearance.  
* Craniopharyngiomas are classified according to their [[Histology|histologic appearance]].  
* The histological appearances of the two pathological subtypes are different, accounting for the different imaging features.
* The histological appearances of the two [[Pathology|pathological subtypes]] are different, accounting for the different imaging features.
* The sub types are said to differ not only in appearances, but also in prognosis and epidemiology.<ref>Classification of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>
* The sub types are said to differ not only in appearances, but also in prognosis and epidemiology.<ref>Classification of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc</ref>


Line 18: Line 18:
|}
|}
**This type is seen predominantly in children.<ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>
**This type is seen predominantly in children.<ref name="pmid27981519">{{cite journal |vauthors=Mortini P |title=Craniopharyngiomas: a life-changing tumor |journal=Endocrine |volume=57 |issue=2 |pages=191–192 |date=August 2017 |pmid=27981519 |doi=10.1007/s12020-016-1192-2 |url=}}</ref>
**It consists of reticular epithelial cells which have appearances reminiscent of the [[enamel]] pulp of developing teeth.
**It consists of [[Reticular|reticular epithelial]] cells which have appearances reminiscent of the [[enamel]] [[Pulp (tooth)|pulp]] of developing teeth.
**There may be single or multiple [[cysts]] filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**There may be single or multiple [[cysts]] filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**"Wet [[keratin]] nodules" are a characteristic histological feature.
**"Wet [[keratin]] nodules" are a characteristic histological feature.
**[[Calcification]] is usually present: 90%
**[[Calcification]] is usually present in 90%
**They are ''more'' locally aggressive.
**They are more locally aggressive.
**It has higher rate of recurrence.
**It has higher rate of recurrence.
**Activating beta-catenin gene mutations are found in adamantinomatous tumors.
**Activating beta-catenin [[gene]] mutations are found in adamantinomatous tumors.




Line 34: Line 34:
**It is formed of masses of metaplastic [[squamous cell]]s.
**It is formed of masses of metaplastic [[squamous cell]]s.
**"Wet [[keratin]]" nodule is absent.
**"Wet [[keratin]]" nodule is absent.
**''[[Cysts]]'' do form, but these are less of a feature, and the tumor is more ''solid''.<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**[[Cysts]] do form, but these are less of a feature, and the tumor is more ''solid''.<ref name="pmid27604996">{{cite journal |vauthors=Müller HL |title=Risk-adapted, long-term management in childhood-onset craniopharyngioma |journal=Pituitary |volume=20 |issue=2 |pages=267–281 |date=April 2017 |pmid=27604996 |doi=10.1007/s11102-016-0751-0 |url=}}</ref>
**[[Calcification]] is uncommon or even rare.
**[[Calcification]] is uncommon or even rare.
**They are less locally aggressive.
**They are less locally aggressive.
**It has ''lower'' rate of recurrence.
**It has lower rate of recurrence.
**BRAF V600E [[mutation]]s are observed in [[papillary]] craniopharyngiomas.
**BRAF V600E [[mutation]]s are observed in [[papillary]] craniopharyngiomas.
*'''Mixed'''
*'''Mixed'''

Revision as of 00:25, 15 February 2019

Craniopharyngioma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Craniopharyngioma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Craniopharyngioma classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Craniopharyngioma classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Craniopharyngioma classification

CDC on Craniopharyngioma classification

Craniopharyngioma classification in the news

Blogs on Craniopharyngioma classification

Directions to Hospitals Treating Craniopharyngioma

Risk calculators and risk factors for Craniopharyngioma classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

There are two subtypes of craniopharyngioma based on the histological and imaging features: Adamantinomatous and papillary.

Classification

  • Craniopharyngiomas are classified according to their histologic appearance.
  • The histological appearances of the two pathological subtypes are different, accounting for the different imaging features.
  • The sub types are said to differ not only in appearances, but also in prognosis and epidemiology.[2]


  • Adamantinomatous
Microscopic pathology of Adamantinomatous craniopharyngioma.jpegSource:Wikimedia Commons
    • This type is seen predominantly in children.[1]
    • It consists of reticular epithelial cells which have appearances reminiscent of the enamel pulp of developing teeth.
    • There may be single or multiple cysts filled with thick oily fluid high in protein, blood products, and/or cholesterol, creating the so called "machinery oil".[3]
    • "Wet keratin nodules" are a characteristic histological feature.
    • Calcification is usually present in 90%
    • They are more locally aggressive.
    • It has higher rate of recurrence.
    • Activating beta-catenin gene mutations are found in adamantinomatous tumors.


  • Papillary
Microscopic pathology of Papillary Craniopharyngioma Source:Wikimedia Commons
    • The papillary subtype is seen almost exclusively in adults.[1]
    • It is formed of masses of metaplastic squamous cells.
    • "Wet keratin" nodule is absent.
    • Cysts do form, but these are less of a feature, and the tumor is more solid.[3]
    • Calcification is uncommon or even rare.
    • They are less locally aggressive.
    • It has lower rate of recurrence.
    • BRAF V600E mutations are observed in papillary craniopharyngiomas.
  • Mixed
    • 15%, but shares imaging features and prognosis similar to adamantinomatous.

References

  1. ↑ 1.0 1.1 1.2 Mortini P (August 2017). "Craniopharyngiomas: a life-changing tumor". Endocrine. 57 (2): 191–192. doi:10.1007/s12020-016-1192-2. PMID 27981519.
  2. ↑ Classification of Craniopharyngioma. Cancer gov. http://www.cancer.gov/types/brain/hp/child-cranio-treatment-pdq#link/_40_toc
  3. ↑ 3.0 3.1 Müller HL (April 2017). "Risk-adapted, long-term management in childhood-onset craniopharyngioma". Pituitary. 20 (2): 267–281. doi:10.1007/s11102-016-0751-0. PMID 27604996.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Craniopharyngioma_classification&oldid=1550284"