Neuropathology for the neuroradiologist: Rosenthal fibers

Distinctive intracellular structures known as inclusions may be occasionally observed on stained tissue preparations and may further suggest a specific diagnosis. Pathologists rely on these findings much as radiologists rely on findings revealed in the gray-scale patterns of densities and intensities on images. Appreciation of these inclusions can enhance the interactions of the neuroradiologist with the neuropathologist and deepen understanding of certain conditions. This report reviews the neuropathologically observed intracellular inclusions known as Rosenthal fibers in the context of Alexander disease and slow-growing tumors such as pilocytic astrocytoma.