Diagnostic neuropathology smears by Jeffrey T. Joseph MD PhD

By Jeffrey T. Joseph MD PhD

This textbook presents sensible details on find out how to practice and interpret smears and use smears for diagnostic intraoperative neuropathology. The publication covers such a lot points of mind biopsies that require intraoperative or ''frozen section'' prognosis, together with tumors, non-neoplastic lesions, infectious ailments, and metastases to the mind. the writer additionally discusses extra common facets of smears, together with their practise and normal interpretation.

Emphasis is at the structural information regarding mind lesions provided via the means of smears, in addition to the styles of smears produced through diverse tumors. greater than two hundred full-color illustrations supplement the text.

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Patient with a history of multiple sclerosis presented with new symptoms and had a scan showing a large, irregularly enhancing lesion in the left hemispheric white matter. qxd 05/10/2006 2:26 PM Page 30 FIGURE 4-9. Acute inflammatory demyelination. A. Low-power view of a needle biopsy, stained with the myelin stain Luxol fast blue combined with hematoxylin and eosin (LFB/H&E). The central pale pink area is relatively devoid of stain and represents an area of demyelination. At the periphery are perivascular cuffs of lymphocytes (arrows).

From about 12 hours to several days, the cytoplasm of infarcted cells undergoes coagulative necrosis, which produces the charac- FIGURE 4-13. Macrophages in demyelination. A. Most of the cytoplasm has been stripped from the macrophages, leaving only naked nuclei (arrowheads). In some cases, a bit of remaining, bubbly, granular, fluffy, or vacuolated cytoplasm will identify the nuclei as belonging to macrophages (arrows). B. Intact macrophage (arrow) and several blebs that have been ripped off of other macrophages (arrowheads).

This view includes some hemosiderin deposits (arrows). An intense reactive gliosis, including inflammatory cells, stretches across the background. On a smear, probably the most useful information suggesting toxoplasmosis is the combination of a mixed inflammatory infiltrate without multinucleated giant cells and the intensely gliotic background. Neutrophils predominate in most bacterial infections. Tuberculosis induces a mostly chronic lymphoplasmacytic inflammation with scattered multinucleated giant cells.

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