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Diagnostic Challenges in Surgical Neuropathology

Castellani, Rudy J. MD

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doi: 10.1097/PCR.0000000000000012
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In this next volume dedicated to brain neoplasia, Pathology Case Reviews brings together a number of prolific scholars in diagnostic neuropathology, including Mark Cohen of Case Western Reserve University, Tony Yachnis of the University of Florida, Rich Prayson of the Cleveland Clinic Foundation, Fausto Rodriquez of Johns Hopkins University, and Kym Gyure of Western Virginia University. Mark Cohen along with Mohamed El Hag et al at the University Hospitals Case Medical Center describe the astroblastoma, a tumor subtype rarely reported since its original description by Bailey and Cushing in 1926. They use this case as a backdrop to a discussion on papillary epithelioid neoplasms in general, which is overdue. Tony Yachnis along with Jesse Lee Kresak and Steven Roper presents a beautifully illustrated case of Lhermitte-Duclos disease and includes an up-to-date discussion of the closely linked familial hamartoma neoplasia syndrome (Cowden disease) and the PTEN/AKT/mTOR signaling pathway. Kym Gyure and Fahad Bafakih tackle the pial melanocyte and discuss the melanocytic schwannoma as a segue to melanocytic lesions, demonstrating in the process Cohen’s contention that the brain is a glorified epidermal inclusion cyst (see El Hag et al in this volume). Inflammatory pseudotumor and its relationship to IgG4 sclerosis disease is discussed by Fausto Rodriquez et al, in a timely and thorough review of that topic. Rich Prayson and Elizabeth Severson remind us of the potential for misadventure between inception and diagnosis of primary brain tumors in their review of brain neoplasia in the forensic pathology setting. Finally, Marie Rivera-Zongotita and Jesse Lee Kresak at the University of Florida provide a nice example and succinct review of the unfortunately named dysembryoplastic neuroepithelial tumor, which has only been in the literature approximately a quarter century and continues to be a source of controversy and diagnostic challenge.

© 2013 by Lippincott Williams & Wilkins.