An undifferentiated neuroblastoma is mostly comprised of neural crest cells, which are sometimes called small round blue cells, due to a lack of cytoplasm, and a large blue nuclei.
Alright, as a quick recap, neuroblastoma is a condition where neural crest cells of the developing sympathetic nervous system and adrenal medulla do not differentiate normally.
There are three types of neuroblastomas, and they're categorized based on the size and shape of the tumor cells: undifferentiated, poorly differentiated, and differentiating neuroblastoma.
In addition, the cells of a poorly differentiated neuroblastoma may be surrounded by a substance called neuropil, which is a dense network of interwoven nerve fibers, like axon and dendrite branches.
If a neuroblastoma cell breaks away and gets into the blood or lymph, it will sometimes migrate towards the organs where CXCL12 is normally produced - creating metastatic tumors there.
Diagnosis of neuroblastoma usually starts with testing for HMA and VMA in the blood or urine, since high levels those metabolites may indicate tumors that secrete epinephrine and norepinephrine.
So, we took him to our pedestrian and within an hour, there was an ambulance at the doctor's office, sending us to Albany Medical Center where right away, they determined that he did have stage 4 neuroblastoma.