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=== | |||
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)]. | ||