Myxopapillary ependymoma: Difference between revisions
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| Micro = Papillary tumor cells around vascular myxoid matrix | | Micro = Papillary tumor cells around vascular myxoid matrix | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[Ependymoma] | | LMDDx = [[Ependymoma]] | ||
| Stains = Alcian blue +ve | | Stains = Alcian blue +ve | ||
| IHC = GFAP +ve | | IHC = GFAP +ve | ||
Revision as of 15:55, 27 April 2015
| Myxopapillary ependymoma | |
|---|---|
| Diagnosis in short | |
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File:File:Myxopapillary ependymoma - very high mag.jpg Myxopapillary ependymoma. H&E stain | |
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| LM | Papillary tumor cells around vascular myxoid matrix |
| LM DDx | Ependymoma |
| Stains | Alcian blue +ve |
| IHC | GFAP +ve |
| Site | usually lumbar spinal cord |
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| |
| 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.
-
Myxopapillary ependymoma in the filum terminale (Dr. E. Michael Scott, Boston, MA). -
Mxyopapillary Ependymoma in the spinal cord, cross section (AFIP)
Histology
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:
Images:
-
Mxyopapillary Ependymoma, HE Smear (AFIP) -
Mxyopapillary Ependymoma, low magnification (WC/Nephron) -
Intermediate magnification (WC/jensflorian -
High magnification (WC/Nephron) -
Mxyopapillary Ependymoma, vascular sclerosis (WC/jensflorian) -
Alcian-blue staining highlighting the mucinous matrix (WC/jensflorian)
- 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.