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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Subependymoma_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Subependymoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = microcysts with bluish material (give a spongy appearance at low magnification), clustering of nuclei cluster (described as "bundles of flowers"), bland nuclei | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[brain]] - see ''[[neuropathology tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = +/-headache | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = classically fourth ventricle | |||
| Endoscopy = | |||
| Prognosis = WHO grade I | |||
| Other = | |||
| ClinDDx = other brain tumours - [[ependymoma]], [[CNS lymphoma]] | |||
| Tx = surgical excision | |||
}} | |||
'''Subependymoma''' is [[neuropathology]] tumour classically found in the fourth ventricle. | |||
==General== | |||
*Good prognosis - WHO Grade I (ICD-O 9383/1). | |||
*Low-grade glial tumour of the middle-aged and elderly.<ref name=pmid23483468/> | |||
*Formerly called ''subependymal (glomerate) astrocytoma'' | |||
Clinical:<ref name=pmid23483468>{{Cite journal | last1 = Castro-Castro | first1 = J. | last2 = Castro-Bouzas | first2 = D. | last3 = Prieto-Casal | first3 = PL. | last4 = Carcacia-Hermilla | first4 = ID. | last5 = Riu-Lloveras | first5 = M. | last6 = Castro-Gómez | first6 = JE. | title = [Subependymoma of the lateral ventricle. A case report]. | journal = Rev Neurol | volume = 56 | issue = 6 | pages = 332-6 | month = Mar | year = 2013 | doi = | PMID = 23483468 }} | |||
</ref> | |||
*Slow growing. | |||
*+/-Headaches. | |||
*CSF obstructions. | |||
*Tx: surgery. | |||
==Gross/radiology== | |||
*Classic location: fourth ventricle (50-60%).<ref>{{Cite journal | last1 = Hoeffel | first1 = C. | last2 = Boukobza | first2 = M. | last3 = Polivka | first3 = M. | last4 = Lot | first4 = G. | last5 = Guichard | first5 = JP. | last6 = Lafitte | first6 = F. | last7 = Reizine | first7 = D. | last8 = Merland | first8 = JJ. | title = MR manifestations of subependymomas. | journal = AJNR Am J Neuroradiol | volume = 16 | issue = 10 | pages = 2121-9 | month = | year = | doi = | PMID = 8585504 |url=http://www.ajnr.org/cgi/reprint/16/10/2121}}</ref> | |||
*Lateral ventricles (30-40% of all cases), rarely IIIrd ventricle, septum pellucideum and spinal cord | |||
*Well-demarcated margin. | |||
*Usu. completely within the ventricle; does not extend into brain (like [[ependymoma]]s). | |||
*May be hemorrhagic. <ref>{{Cite journal | last1 = Landriel | first1 = F. | last2 = Besada | first2 = C. | last3 = Migliaro | first3 = M. | last4 = Christiansen | first4 = S. | last5 = Goldschmidt | first5 = E. | last6 = Yampolsky | first6 = C. | last7 = Ajler | first7 = P. | title = Atypical hemorrhagic presentation of a fourth ventricle subependymoma: case report. | journal = Neurol Med Chir (Tokyo) | volume = 53 | issue = 11 | pages = 828-31 | month = | year = 2013 | doi = | PMID = 24140775 }}</ref> | |||
*Usually less than 2cm in diameter. | |||
*Incidentally found at autopsies. | |||
===Images=== | |||
<gallery> | |||
File:AFIP405740R-SUBEPENDYMOMA.jpg | Subependymoma (AFIP) | |||
File:Subependymoma.jpg | Macroscopy (AFIP) | |||
</gallery> | |||
==Microscopic== | |||
Features:<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/Com05/Com501-2-Diss.htm http://moon.ouhsc.edu/kfung/jty1/Com05/Com501-2-Diss.htm]. Accessed on: 2 June 2011.</ref> | |||
*Microcysts with bluish material - give a spongy appearance at low magnification. | |||
*Isomorphic nuclei cluster embedded into fibrillary matrix. | |||
**Described as "bundles of flowers". | |||
*Calcifications possible | |||
*Combined subependymomas/classical cellular ependymomas (then grade II) | |||
Negatives. | |||
*No nuclear pleomorphism, no prominent nucleoli, no mitoses. | |||
*Do not invade into brain.<ref name=pmid23483468/> | |||
===Images=== | |||
www: [http://moon.ouhsc.edu/kfung/jty1/Com05/Com05Image/Com501-2-04.gif Subependymoma (ouhsc.edu)].<ref name=ouhsc>URL: [http://moon.ouhsc.edu/kfung/jty1/Com05/Com501-2-Diss.htm http://moon.ouhsc.edu/kfung/jty1/Com05/Com501-2-Diss.htm]. Accessed on: 2 June 2011.</ref> | |||
<gallery> | |||
File:Subependymoma HE x40.jpg | Subependymoma - low mag. (WC/jensflorian) | |||
Image:Subependymoma_-_intermed_mag.jpg | Subependyoma - intermed. mag. (WC) | |||
Image:Subependymoma_-_high_mag.jpg | Subependymoma - high mag. (WC) | |||
File:Subependymoma 2 - high mag.jpg | Subependymoma - high mag. (WC/Nephron) | |||
Image:Subependymoma_-_very_high_mag.jpg | Subependymoma - very high mag. (WC) | |||
File:AFIP405743M-SUBEPENDYMOMA.jpg | Subependymoma (AFIP) | |||
</gallery> | |||
DDx: | |||
[[Ependymoma]] | |||
==IHC== | |||
*GFAP+ve | |||
*MIB-1 very low (1%) | |||
*ATRX: no loss | |||
*IDH1(R132H)-ve | |||
==Molecular== | |||
*Posterior fossa and spine: chr.6 alterations. | |||
*Supratentorial: No consistent abberations. | |||
==See also== | |||
*[[Neuropathology tumours]]. | |||
*[[Neuropathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Neuropathology tumours]] | |||