Intracerebral metastases pathophysiology

Intracerebral metastases Microchapters
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Pathophysiology

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:

• Cerebrum (80%)
• Cerebellum (15%)
• Brain stem (5% )

Gallery

• 

  _{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.).}

Microscopic Pathology

The histopathological appearance of intracerebral metastases may vary with the type of primary cancer. Common findings are listed below:

• Tubule formation/glands
• Usually 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

• 

  _{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.}

• 

  _{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.}

• 

  _{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.}

• 

  _{Adenocarcinoma infiltrating the brain in a case of lung cancer on H&E stain.}

References

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