Intracranial Tumours Pathological Classification

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MENINGES

NERVE

SHEATH

CELLS

BLOOD VESSELS

- Meningioma: Arise from the arachnoid granulations, usually closely related to the venous sinuses but also found over the hemispheric convexity. The tumours compress rather sU^-^y'd Whorls of fibrous tissue and spindle cells

^Calcified psammoma bodies

than invade adjacent brain. They also occur in the skull base, spinal canal and orbit. Most are benign (despite their tendency to invade adjacent bone) but some undergo sarcomatous change. Histological types - syncytial, transitional, fibroblastic and angioblastic. The haemangio-pericytoma variant is poorly differentiated and aggressive in nature. L-» Meningeal sarcoma and primary Meningeal melanoma: Exceedingly rare tumours.

(Syn. neurilemmoma/schwannoma): a non-invasive, slowly growing tumour of the Schwann cells, surrounding the vestibular part of the VIII cranial nerve roots or the peripheral nerves. Different histological types exist:

Antoni type A Antoni type B

see page 321

• Neurofibroma: tumour of Schwann cells and fibroblasts producing a fusiform expansion through which nerve fibres run. It involves the spinal nerve roots or peripheral nerves but rarely affects cranial nerves and has a greater tendency to undergo malignant change than schwannoma. This tumour is the type associated with Von Recklinghausen's disease, although schwannomas and mixed tumours also occur (see page 540). n.b. Many tumours have mixed characteristics in varying proportions.

Haemangioblastoma: Occurs within the cerebellar parenchyma or spinal cord. In 1926, Lindau described a syndrome relating cerebellar and/ or spinal haemangioblastomas with similar tumours in the retina and cystic lesions in the pancreas and kidney (Von Hippel-Lindau disease).

>7--Cerebellar hemisphere

Reddish brown tumour nodule lying in the wall of the cyst. Histology shows a mass of blood vessels separated by clear, foamy vacuolated cells

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