science

Papillary tumors of the pineal region

Papillary tumors of the pineal region is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Papillary tumors of the pineal region rather than just read about it. In short: Papillary tumors of the pineal region were first described by A. Jouvet et al. in 2003 and were introduced in the World Health Organization (WHO) classification of central nervous system in 2007.

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Reference excerpt

Papillary tumors of the pineal region were first described by A. Jouvet et al. in 2003 and were introduced in the World Health Organization (WHO) classification of central nervous system in 2007. Papillary Tumors of the Pineal Region are located on the pineal gland which is located in the center of the brain. The pineal gland is located on roof of the diencephalon. It is a cone-shaped structure dorsal to the midbrain tectum. The tumor appears to be derived from the specialized ependymal cells of the subcommissural organ. Papillary tumors of the central nervous system and particularly of the pineal region are very rare and so diagnosing them is extremely difficult.

Symptoms and signs The most common symptom of the papillary tumor 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 do not stop. 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. Often when hydrocephalus occurs, a shunt is put in place to alleviate the pressure. In one case study, an endoscopic third ventriculostomy was performed as a first line procedure to treat the hydrocephalus and also for diagnostic purposes. In some cases, patients have had progressive diplopia, or double vision. Also, although not in all cases, patients sometimes experience nausea and vomiting.

Pathology

Pineal region tumors are normally composed of a variety of cells including astrocytes, ganglion cells, blood vessels, and pinealocytes, which are the cells of this organ. Pinealocytes are specialized neurons, which are rich in monoaminergic neurotransmitters, including, serotonin, norepinephrine, and melatonin. Specifically, papillary tumors of this region are made up of ependymal cells which form papilla. The papilla is meant to be surface cells. The ependymal cells line the inside of the ventricles of the brain. These cells have proteins that make up the characteristics of the tumor. These proteins arise from blood vessels, nerve cells and muscle cells. These tumors, papillary tumors in this case, have no known predisposing genetic characteristics, as stated by Dr. Janss when I interviewed her. She said that there is nothing that links the likelihood of getting this tumor type to genetics, meaning nothing is inherited. However, technically speaking, there is genetics involved, just not in the sense of inheritability. The tumor cells may differ in their structure and function, but they all have normal function, which is directed by the deoxyribonucleic acid, or DNA. There are meant to be certain cells in a specific area, for the pineal region these are ependymal cells, and the cells divide into millions. As these cells divide, their genetic material is being copied. In a tumor, there is a collection of mutations that are typos in the genetic material, which disrupts the function of the normal cell. Therefore, the cells differentiate from what they were meant to be. If the abnormal cells continue to grow, divide, and produce more abnormal cells, the mass of abnormal cells may eventually become a tumor. Papillary tumors of the pineal region are normally well circumscribed. They are reported to be fairly large ranging between 2.5 and 4.0 centimeters. These tumors sometimes feature a cystic component.

Histological and immunohistochemical features The 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 tumors, papillary ependymoma, papillary meningioma, choroid plexus papilloma, and metastatic papillary carcinoma. Papillary tumors characteristically show a discrete, compressive border with adjacent pineal gland and brain parenchyma. The nuclei tend to be regular, round-to-oval and contain stippled chromatin. The 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. The cells of this tumor usually show a columnar to cuboidal cytoplasm with a well-defined cytoplasmic membrane. Vacuolated, or clear cells are common. Necrosis or cell death is normally observed to some extent in most of these tumors cells. These 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. There is normally cytoplasmic staining for a number of cytokeratins and the immunohistochemical profile for the papillary tumors are as follows: AE1/AE3 (pan-cytokeratin) → - CK8/18 (cytokeratin 8/18) → +++ EMA (epithelial membrane antigen) → - GFAP (glial fibrillary acidic protein) → + Synaptophysin → - Chromogranin → - NSE (neuron-specific enolase) → ++ NFP (neurofilament protein) → - CD56/N-CAM (neural cell adhesion molecule) → ++ S100 → ++ Transthyretin → - Vimentin → +++ Desmin → - SMA (smooth muscle actin) → + The intensity of immunoreactivity was scored as follows: - (absent), + (weak/focal), ++ (moderate), and +++ (strong).

Diagnosis

Grading

Papillary tumor of the pineal region is a recently described neoplasm that has been formally recognized in the 2007 World Health Organization (WHO) "Classification of Tumors of the Nervous System." Because these tumors are so rare, at first there was really no way to grade these tumors. Once they were biopsied, they were defined as either malignant, meaning cancerous, or benign, meaning cancer free. After seeing more and more cases of this tumor, they are now determined to be either Grade II or Grade III, according to the WHO classification. The mitotic activity varies for these tumors, ranging from 0 to 10 mitoses per 10 high power (x40) fields.

Grade II Grade II tumors are relatively slow growing. They have a slightly abnormal microscopic appearance and can spread into nearby normal tissue. Grade II tumors can also recur as a higher-grade tumor.

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Illustrations

Worked examples

Example 1 — a first encounter with Papillary tumors of the pineal region

Start with the simplest possible case. Write down what Papillary tumors of the pineal region claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Papillary tumors of the pineal region before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Papillary tumors of the pineal region ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Papillary tumors of the pineal region

In research: Papillary tumors of the pineal region appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Papillary tumors of the pineal region in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Papillary tumors of the pineal region is common in secondary-school and first-year university syllabi. It links to neighbouring topics Endocrine neoplasia, Types of neoplasia, so understanding it makes those chapters shorter.
In everyday life: Look for Papillary tumors of the pineal region outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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Frequently asked questions

What is Papillary tumors of the pineal region in simple terms?

Papillary tumors of the pineal region were first described by A. Jouvet et al. in 2003 and were introduced in the World Health Organization (WHO) classification of central nervous system in 2007.

Why does Papillary tumors of the pineal region matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Papillary tumors of the pineal region?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Papillary tumors of the pineal region.