User:Chelsea Proffitt/sandbox

Location
Papillary Tumors of the Pineal Region are located on pineal gland

Pineal gland located on roof of diencephalon ** Oncology **

Pineal gland is a cone shaped structure dorsal to the midbrain tectum ** Oncology **

tumor appears to be derived from specialized ependymal cells of the subcommissural organ ** Tumor in Child **

Function of Pineal Gland
Has specialized neurons rich in monoaminergic NT - serotonin, norepinephrine, and melatonin ** Oncology**

Believed to control biological rhythm of body **A Primer of Brain Tumors **

Background of Pineal Region Tumors
Composed of variety of cells - astrocytes, ganglion cells, blood vessels, pinocytes (cells of this organ)  ** Oncology **

Tumors of pineal gland rare - 0.4-1% of all CNS tumors ** Oncology**

Causes
papillary tumors of the central nervous system and particularly the pineal region are rare ** MR Imaging ** critical diagnosis of this neoplasm is often difficult because of its similarity with other primary or secondary papillary lesions of the pineal region, including parenchymal pineal tumours, papillary ependymoma, papillary meningioma, choroid plexus papil- loma and metastatic papillary carcinoma ** Brain Pathology**

Grading of Tumor
Papillary tumor of the pineal region (PTPR) is a recently described neoplasm that has been formally recognized in the 2007 World Health Organization (WHO) “Classification of Tumors of the Nervous System.”  ** MR Imaging **

Grade II
A Primer of Brain Tumors

relatively slow growing

has slightly abnormal microscopic appearance

can spread into nearby normal tissue

can recur as higher grade tumor

Grade III
A Primer of Brain Tumors

Malignant

Cells are actively reproducing abnormal cells

grow into nearby normal brain tissue

Tumors tend to recur as higher grade

Symptoms
The most common symptom is a headache. Because headaches are so common, most people think nothing of it. This is why brain tumors are so dangerous. There are not a lot of symptoms that go along with them so people tend to wait a long time before seeking medical help. Most of the time people will go see a doctor when their headaches become consistent and start to never go away. This symptom however occurs secondary to hydrocephalus, which is a result from compression of the cerebral aqueduct. The cerebral aqueduct is a narrow channel in the midbrain, which connects the third and fourth ventricles. When a tumor blocks the pathway of the cerebrospinal fluid, this will cause headaches in the patient. ** Boco **

Progressive diplopia on later gaze ** Boco **

Histological and Immunohistochemical features
Characteristically show a discrete, compressive border with adjacent pineal gland and brain parenchyma ** WHO Classification **

Nuclei are regular, round – to – oval and contain stippled chromatin ** WHO **

Apoptotic features were numerous. Mitoses were sparse and necrosis was absent. **Boco**

tumors were tested immunohistochemically with a profile similar to that of a choroid plexus tumor; however, morphologically the tumors appeared to be less differentiated than a choroid plexus papilloma and more differentiated than a choroid plexus carcinoma ** Knife radiosurgery ** cytoplasmic staining for a number of cytokeratins, including Cam 5.2, MNFI16, AEI and AE3, cytokcratin 7 and cytokeratin 20 ** Pathological Entity ** Cytoplasmic and often nuclear expression of S100 protein is present in nearly all tumor cells, and vimentin typically stains tumor cell cytoplasm adjacent to vessel walls. ** WHO **