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Neuroblastoma

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• Characteristics of Neuroblastoma
• one of the most common tumors of childhood
• 80% found in children under 5 yrs of age, 35% under 2 yrs
• Found in variety of locations due to neural crest cell origin 
  - adrenal medulla & posterior abdominal wall (retroperitoneal tissues) make up 50-80%
  - second most common site is in the posterior mediastinum usually in paravertebral locations
  - the remainder occur in the pelvis, cervical region, & lower abdominal sympathetic chain

 
• Diagnosis of Neuroblastoma
• Histology
  -Cells are small and dark, resembling lymphocytes
  -The cells are often arranged in masses without any true pattern of organization
  -Characteristic hallmark;  Rosettes occur where the tumor cells occupy the periphery and nerve fibrils grow into the center of the
    rosette. While these rosettes are almost always present, they sometimes can be difficult to locate.
• Metastases develop rapidly and spread to the lymph nodes, liver, lungs, and bones (3/4 of patients have metastasized by time of diagnosis).
• 90% of Neuroblastomas elaborate catecholamines (mostly norepinephrine) which is of diagnostic significance
  
  
• Clinical Course
• Loss of energy and weight
• Pallor
• Abdominal protrusion
• irregular fever and maliase