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Sure! Let’s break down neuroblastoma vs ganglioneuroma in a detailed, organized way, focusing on their differences in origin, pathology, clinical features, imaging, and prognosis.
1. Origin / Pathogenesis
| Feature | Neuroblastoma | Ganglioneuroma |
|---|---|---|
| Cell of origin | Neural crest cells (sympathetic nervous system) | Mature sympathetic ganglion cells (from neural crest) |
| Maturation | Undifferentiated or poorly differentiated | Fully differentiated, benign |
| Age of presentation | Usually <5 years old | Usually older children or adults (can be any age) |
| Malignancy | Malignant | Benign |
2. Histology / Pathology
| Feature | Neuroblastoma | Ganglioneuroma |
|---|---|---|
| Cell type | Small, round, blue cells; undifferentiated | Mature ganglion cells with Schwannian stroma |
| Stroma | Sparse | Abundant Schwannian stroma |
| Differentiation | Poor | Well-differentiated |
| Mitotic activity | High | Low / minimal |
| Necrosis / hemorrhage | Often present | Rare |
| Calcification | Common | May be present |
3. Clinical Features
| Feature | Neuroblastoma | Ganglioneuroma |
|---|---|---|
| Symptoms | Abdominal mass, pain, weight loss, fever, hypertension (from catecholamines) | Often asymptomatic; may cause mass effect or incidental finding |
| Catecholamine secretion | Often ↑ urinary VMA/HVA | Rarely secretory |
| Paraneoplastic syndromes | Opsoclonus-myoclonus, diarrhea (VIP) | Usually absent |
4. Imaging
| Feature | Neuroblastoma | Ganglioneuroma |
|---|---|---|
| Modality | Ultrasound, CT, MRI, MIBG scan | CT, MRI |
| Appearance | Heterogeneous, calcifications, invasive, may encase vessels | Homogeneous, well-circumscribed, rarely encases vessels |
| Metastasis | Common at diagnosis (bone, liver, lymph nodes) | Rare |
5. Prognosis
| Feature | Neuroblastoma | Ganglioneuroma |
|---|---|---|
| Outcome | Variable; depends on age, stage, MYCN amplification | Excellent; essentially curable with surgery |
| Treatment | Surgery + chemotherapy ± radiation | Surgery only |
Key Takeaways
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Neuroblastoma: malignant, aggressive, undifferentiated; young children; catecholamine-secreting; often metastasizes.
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Ganglioneuroma: benign, fully differentiated; older children/adults; usually asymptomatic; no metastasis.
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They represent a spectrum: neuroblastoma → ganglioneuroblastoma → ganglioneuroma, with increasing differentiation and decreasing malignancy.
If you want, I can also make a quick visual table showing the “spectrum of differentiation” from neuroblastoma to ganglioneuroma, which is very helpful for memorization.
Do you want me to do that?
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