Neuropath boards are over!!!

I just finished taking the neuropathology boards in Tampa, Florida. That was an interesting experience. In a sense, I do think that it is an adequate test for licensure purposes... It proves that if one can make esoteric diagnoses on a single low-power, low-resolution, barely-representative image in the complete absence of relavent clinical details, one can easily make an adequate diagnosis on a well-stained actual glass slide using a real microscope... 

Glad it's over! Hope I don't have to do it again too soon...

Interesting case - 9.3.2011

Here's another case that came through the UTSW neuropathology service, kindly provided by Dr. Mathis...

This patient was a 17-year-old female with a long seizure history. An EEG demonstrated an epileptogenic focus in the region of the left temporal lobe, which corresponded to a non-enhancing mass in the lateral aspect of the left temporal lobe (unfortunately imaging unavailable). Surgical resection yielded the following pathology specimen... 

H&E; low power

H&E; intermediate power

H&E; high power

H&E; high power

GFAP immunostain

Synaptophysin immunostain

CD31 immunostain

Epithelial membrane antigen (EMA) immunostain

No good hints here. Key elements in the history and recognition of the unique growth pattern are key to the diagnosis in this case...

Click here for the diagnosis...