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Histology of the central nervous system

Children can develop the same type of intracranial tumors as adults. Although, some tumors are more frequent in childhood.


MR image of patient with pilocytic astrocytoma. Click to enlarge. Photomicrograph demonstrating astrocytoma. Click to enlarge.

These tumors originate from astrocytes. According to the WHO classification they are graded from 1 to 4. Grades 3 and 4, the most malignant, are seldom seen in children. Astrocytoma grade 1 = pilocytic astrocytoma and grade 2 = fibrillary astrocytoma, also designated low-grade astrocytomas, are more frequent in children compared to adults. The most frequent type in childhood is the pilocytic astrocytoma, which is often located in the cerebellum.


MR image of patient with medulloblastoma. Click to enlarge.

Medulloblastoma is the most common highly malignant brain tumor in children. It is an undifferentiated neuroepithelial tumor (Primitive Neuroectodermal Tumor - PNET) in the cerebellum. Similar tumors originating in other parts of the brain are called PNET, and not medulloblastma.


MR image from a patient with anaplastic ependymoma. Click to enlarge.

Ependymoma originate from the covering of ependymal cells in the ventricular system or in the central canal of the spinal medulla. The forth ventricle is the most common location for this tumor in children. 


MR image of a patient with craniopharyngeoma. Click to enlarge.

Craniopharyngiomas originate from embryonal remains of the ductus craniopharyngeus (Rathkes duct), and are most commonly seen around the hypophyseal stalk and in the lower part of the third ventricle. These tumors can be both cystic and solid. Despite lacking malignant features, they can infiltrate brain tissue (adamantinous type).

Choroid plexus papillomas

MR image of a patient with plexus papilloma. Click to enlarge.

These are intraventricular tumors that can infiltrate surrounding brain tissue. They can be large with abundant blood vessels and produce a great amount of cerebrospinal fluid to induce hydrocephalus. About 10% are histologically malignant and are then called choroid plexus carcinomas.

Germinal cell tumors

Germ cell tumors originate from primitive germ cells and are similar to those germ cell tumors appearing in the testis and ovaries. These tumors are most frequent in the pineal gland and in the lower part of the third ventricle. The most common type is germinoma (similar to seminoma of the testis and dysgerminoma of the ovary).         

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