Brain metastasis: clinical characteristics, pathological findings and molecular subtyping for therapeutic implications

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• 作者：Hidehiro Takei ; Emilie Rouah ; Yusuke Ishida
• 关键词：Brain metastasis ; Immunohistochemistry ; Differential diagnosis ; Unique histologic patterns ; Molecular alterations
• 刊名：Brain Tumor Pathology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：33
• 期：1
• 页码：1-12
• 全文大小：2,021 KB
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• 作者单位：Hidehiro Takei (1)
  Emilie Rouah (2)
  Yusuke Ishida (3)
  
  1. Department of Diagnostic Pathology, Asahikawa Medical University, 2-1-1-1 Midorigaoka Higashi, Asahikawa, Hokkaido, 078-8510, Japan
  2. Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
  3. Department of Clinical Pathology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
  
• 刊物主题：Neurosurgery; Neurology; Pathology; Oncology; Cancer Research;
• 出版者：Springer Japan
• ISSN：1861-387X

文摘

Metastases are the most common brain tumors especially in adults. Although they are generally considered a single disease entity which is universally fatal in patients with advanced cancer, brain metastases are remarkably heterogeneous both clinically and pathologically. As members of the multidisciplinary clinical team for the diagnosis and management of metastatic brain tumors, pathologists must be familiar not only with clinicopathologic features of brain metastases but also with any characteristic and clinically significant molecular findings. We discuss here the epidemiology, general gross and microscopic features of brain metastases with emphasis on how to differentiate them from primary brain tumors using immunohistochemistry (e.g., for identification of the primary site and differential diagnosis), and unique pathologic patterns of brain metastases (namely, dural metastasis, leptomeningeal carcinomatosis, miliary metastasis, “intravascular carcinomatosis”, and tumor-to-tumor metastasis) with their clinical and radiological characteristics. We specifically address metastatic breast and non-small cell lung cancers which are the two most commonly encountered in daily practice, with emphasis on the molecular alterations related to therapy and their clinicopathologic significance. Keywords Brain metastasis Immunohistochemistry Differential diagnosis Unique histologic patterns Molecular alterations