CNS2病理3Classical Disease Patterns.ppt

主要内容 掌握神经系统的细胞及其基本病变； 掌握常见神经系统肿瘤特点； 掌握常见变性疾病的病理特点； 掌握流脑和乙脑的病理特点； 掌握常见缺氧和脑血管病。 思考题： 1. Alzheimer病的病理特点？ 2. Parkinson病的病理特点？ 3. 脑组织中蛋白质异常聚集的机制有哪些？哪些疾病可能有蛋白质异常聚集？ 竺可青 病理学与法医学研究所 神经科学研究所 浙江大学医学院中国人脑库 zhukeqing@zju.edu.cn 主要内容 掌握神经系统的细胞及其基本病变； 掌握常见神经系统肿瘤特点； 掌握常见变性疾病的病理特点； 掌握流脑和乙脑的病理特点； 掌握常见缺氧和脑血管病。 思考题： 1. Alzheimer病的病理特点？ 2. Parkinson病的病理特点？ 3. 脑组织中蛋白质异常聚集的机制有哪些？哪些疾病可能有蛋白质异常聚集？ 竺可青 病理学与法医学研究所 神经科学研究所 浙江大学医学院中国人脑库 zhukeqing@zju.edu.cn * Glioma, intermediate grade * Glioma, high grade, Note NECROSIS. NECROSIS is needed for the diagnosis of a HIGH grade glioma. The higher grade gliomas merit the term GBM (GlioBlastome Multiforme), which need the presence of NECROSIS for a correct diagnosis, but pleormorphism and palisading usually can be easily demonstrated as well. * Glioblastoma (multiforme). Why is it called “multiforme”? Note the 1) palisading and 2) necrosis which are hallmarks of GBM. * Central necrosis is a sign of rapid growth. It outgrows its blood supply, and therefore liquefies centrally, like an abscess. * What kinds of glial cells are these? * Question #8: PR-oteinaceous I-nfectious particle = PRI-on * Hence the term “spongiform.” * The PLAQUE of MS is NOT like a plaque of skin diseases or Alzheimer disease. In MS the plaque is a demyelinated area. * MS gave MRI its first HUGE boom, by virtue of being able to detect these lesions, due to edema! Where do you see MS in the brain? Ans: Wherever there is white matter! * Myelinated white matter stains BLUE, and demyelination is loss of blue. Remember MS is a disease PRIMARILLY of WHITE matter. If you have a good sense of symmetry, you done need to go to neuropathologist school. * Plaques grossly, do some areas in the brain white matter look “less” white? * Plaques microscopically. Demyelination, edema, gliosis, and, lower right, relative “preservation” of the actual nerve fibers, usung a nerve fiber stain, like wires without insulation! * Question #10 FOUR classical areas for brain degeneration, a