Ependymoma: Difference between revisions

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Jensflorian (talk | contribs)
Molecular: Update
Jensflorian (talk | contribs)
Microscopic: Spinal ependymoma
 
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*Approx. 1/3 of all ependymal tumours (41% in children).
*Approx. 1/3 of all ependymal tumours (41% in children).
*Irregular CM enhancement.
*Irregular CM enhancement.
*YAP1-fused tumors in children oft large at time of diagnosis.
*Cysts and/or calcification possible.
*Cysts and/or calcification possible.
*Sharply demarcated from adjacent brain parenchyma.
*Sharply demarcated from adjacent brain parenchyma.
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*Complete surgical resection is the best predictor.
*Complete surgical resection is the best predictor.
*CSF spread in up to 15% of tumours.
*CSF spread in up to 15% of tumours.
===Posterior fossa ependymoma===
*Usu. 4th ventricle, less common in CPA.
*Most frequent in children.
*May contain tumour nodules with increased cell density.
*Micocysts, vascular hyalinization and calcification can be present.
*No morphologic differences between Group A and B tumours.
*Perivascular pseudorosettes almost always present.
*Rare papillary or tanicytic patterns.


DDx (supratentorial and posterior fossa ependymoma):
DDx (supratentorial and posterior fossa ependymoma):
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*[[Oligodendroglioma]] (Clear cell ependymoma))
*[[Oligodendroglioma]] (Clear cell ependymoma))
*CNS embryonal tumour with BCOR internal tandem duplication.
*CNS embryonal tumour with BCOR internal tandem duplication.
===Spinal ependymoma===
*Isomorphic nuclei.
*Mitotic activity usu. very low.
*Calcification, hemorrhage, cystic and/or metaplastic changes may be seen.
*Most tumours show CNS grade 2 histology.
**CNS grade 3 tumours should be examined for MYCN amplification.
*Outcome usu. good, extent of resection is prognostic.


DDx (spinal ependymoma):
DDx (spinal ependymoma):
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*Small cell glioblastoma (MYCN-amplified spinal ependymoma)
*Small cell glioblastoma (MYCN-amplified spinal ependymoma)


====Images====
===Images===
www:
www:
*[http://www.flickr.com/photos/ckrishnan/3862487821/in/photostream Ependymoma (flickr.com)].
*[http://www.flickr.com/photos/ckrishnan/3862487821/in/photostream Ependymoma (flickr.com)].