Difference between revisions of "Myxopapillary ependymoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Myxopapillary_ependymoma_-_very_high_mag.jpg | | Image = Myxopapillary_ependymoma_-_very_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = Myxopapillary ependymoma. [[ | | Caption = Myxopapillary ependymoma. [[HPS stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = Papillary tumor cells around vascular myxoid matrix | | Micro = Papillary tumor cells around vascular myxoid matrix | ||
| Subtypes = subtype of [[ependymoma]] | | Subtypes = subtype of [[ependymoma]] | ||
| LMDDx = [[ | | LMDDx = [[chordoma]], [[myxoid chondrosarcoma]], [[paraganglioma]], papillary [[adenocarcinoma]] | ||
| Stains = Alcian blue +ve | | Stains = Alcian blue +ve | ||
| IHC = GFAP +ve | | IHC = GFAP +ve | ||
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==Gross== | ==Gross== | ||
* | *Soft. | ||
* | *Gray. | ||
* | *Discrete masses. | ||
* | *Often encapsulated. | ||
*Subtotal resected tumors may spread throughout the neuraxis. | *Subtotal resected tumors may spread throughout the neuraxis. | ||
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</gallery> | </gallery> | ||
== | ==Microscopic== | ||
Features: | Features: | ||
*Papillary appearance. | *Papillary appearance. | ||
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*Microcysts. | *Microcysts. | ||
*Low mitotic activity. | *Low mitotic activity. | ||
Note: | Note: | ||
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DDx: | DDx: | ||
* [[Chordoma]] | * [[Chordoma]]. | ||
* [[Myxoid chondrosarcoma]] | * [[Myxoid chondrosarcoma]]. | ||
* [[Paraganglioma]] | * [[Paraganglioma]]. | ||
* Papillary [[ | * Papillary [[adenocarcinoma]]. | ||
===Images=== | |||
<gallery> | <gallery> | ||
File:Myxopapillary_ependymoma.jpg | Mxyopapillary Ependymoma, HE Smear (AFIP) | File:Myxopapillary_ependymoma.jpg | Mxyopapillary Ependymoma, HE Smear (AFIP) | ||
File:Myxopapillary_ependymoma_-_intermed_mag.jpg | Mxyopapillary Ependymoma, low magnification (WC/Nephron) | File:Myxopapillary_ependymoma_-_intermed_mag.jpg | Mxyopapillary Ependymoma, low magnification (WC/Nephron) | ||
File:Myxopapillary_ependymoma-HE.jpg | Intermediate magnification (WC/jensflorian | File:Myxopapillary_ependymoma-HE.jpg | Intermediate magnification (WC/jensflorian) | ||
File:Myxopapillary_ependymoma_-_very_high_mag.jpg | High magnification (WC/Nephron) | File:Myxopapillary_ependymoma_-_very_high_mag.jpg | High magnification (WC/Nephron) | ||
File:Myxopapillary_ependymoma_HE_x40.jpg | Mxyopapillary Ependymoma, vascular sclerosis (WC/jensflorian) | File:Myxopapillary_ependymoma_HE_x40.jpg | Mxyopapillary Ependymoma, vascular sclerosis (WC/jensflorian) | ||
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==Molecular== | ==Molecular== | ||
* Poorly characterized | * Poorly characterized. | ||
* No consistent abberations. | * No consistent abberations. | ||
==See also== | ==See also== |
Latest revision as of 04:11, 2 May 2015
Myxopapillary ependymoma | |
---|---|
Diagnosis in short | |
Myxopapillary ependymoma. HPS stain. | |
| |
LM | Papillary tumor cells around vascular myxoid matrix |
Subtypes | subtype of ependymoma |
LM DDx | chordoma, myxoid chondrosarcoma, paraganglioma, papillary adenocarcinoma |
Stains | Alcian blue +ve |
IHC | GFAP +ve |
Site | usually lumbar spinal cord |
| |
Prognosis | good (WHO Grade I) |
Mxyopapillary Ependymoma, is a low-grade Ependymoma. It is nearly always associated with cauda equina and filum terminale.
General
- Low-grade ependymoma - WHO Grade I by definition.
- Classically in the spinal cord of adults.
- Approx 9-13% of all ependymal tumors.[1]
- Associated with back pain.
- Enhancing mass
Gross
- Soft.
- Gray.
- Discrete masses.
- Often encapsulated.
- Subtotal resected tumors may spread throughout the neuraxis.
Microscopic
Features:
- Papillary appearance.
- Perivascular pseudorosettes:
- Cuboidal to elongated tumor cells.
- Radially arranged around vascular cores.
- Myxoid material surround blood vessels.
- Microcysts.
- Low mitotic activity.
Note: Cases with extensive sclerosis may mimic degenerative changes. [2]
DDx:
- Chordoma.
- Myxoid chondrosarcoma.
- Paraganglioma.
- Papillary adenocarcinoma.
Images
- Myxopapillary ependymoma - high mag. (WC).
- Myxopapillary ependymoma (bmj.com) - part of careers.bmj.com article on paediatric pathology.
- Myxopapillary ependymoma - cytology (WC).
- Myxopapillary ependymoma - several images (upmc.edu).
IHC
- GFAP+ve.
- S-100+ve.
- MIB-1 <1%.
Molecular
- Poorly characterized.
- No consistent abberations.
See also
References
- ↑ Schiffer, D.; Chiò, A.; Giordana, MT.; Migheli, A.; Palma, L.; Pollo, B.; Soffietti, R.; Tribolo, A. (Aug 1991). "Histologic prognostic factors in ependymoma.". Childs Nerv Syst 7 (4): 177-82. PMID 1933913.
- ↑ Schittenhelm, J.; Becker, R.; Capper, D.; Meyermann, R.; Iglesias-Rozas, JR.; Kaminsky, J.; Mittelbronn, M.. "The clinico-surgico-pathological spectrum of myxopapillary ependymomas--report of four unusal cases and review of the literature.". Clin Neuropathol 27 (1): 21-8. PMID 18257471.