Choroid plexus papilloma

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Choroid plexus papilloma
Diagnosis in short

Choroid plexus papilloma H&E stain.

LM Papillary epithelial structures.
LM DDx metastatic papillary adenocarcinoma, ELST
IHC Kir 7.1+ve, EAAT1+ve, GFAP+/-, S-100+/-, CK+/-
Site all ventricles, cerebellopontine angle

Symptoms hydrocephalus
Prevalence Children


Choroid plexus papilloma is a benign neuropathology arising in the ventricles of the brain.

General

Features: [1]

  • Low grade
    • WHO grade I (ICD-O: 9390/1).
    • WHO grade II - atypical choroid plexus papilloma (ICD-O: 9390/1).
  • Less than 1% of all brain tumors.
    • Approx. 10-20% of all tumors in the first year of life.
    • Congenital tumors reported.
  • Usu. laternal ventricle in kids.[2]

Gross

Features: [1]

  • Adhere to ventricular walls.
  • Circumscribed.
  • Villous architecture.
  • 50% lateral ventricles.
  • 5% third ventricle.
  • 40% fourth ventricle.
  • 5% multiple tumors or cerebellopontine angle.

Microscopic

Features: [3]

  • Simple epithelium.
  • Papillae.
  • Psammoma bodies.
  • Rarely oncocytic changes, mucinous degeneration.
  • Necrosis and brain invasion is uncommon.
  • Atypical CPP: 2 or more mitoses /10 HPF.[4]


IHC

  • CK7+ve.
  • CK20-ve (typically).
  • S-100+/-.
  • EMA-ve.
  • GFAP +/-.
  • Kir 7.1+ve.
  • EAAT1+ve.

Images

www:

See also

References

  1. 1.0 1.1 The International Agency for Research on Cancer (Editors: Louis, D.N.; Ohgaki, H.; Wiestler, O.D.; Cavenee, W.K.) (2007). Pathology and Genetics of Tumours of Tumors of the Central Nervous System (IARC WHO Classification of Tumours) (4th ed.). Lyon: World Health Organization. pp. 82. doi:10.1007/s00401-007-0243-4. ISBN 978-9283224303.
  2. URL: http://emedicine.medscape.com/article/250795-overview. Accessed on: 3 June 2011.
  3. Menon, G.; Nair, SN.; Baldawa, SS.; Rao, RB.; Krishnakumar, KP.; Gopalakrishnan, CV.. "Choroid plexus tumors: an institutional series of 25 patients.". Neurol India 58 (3): 429-35. doi:10.4103/0028-3886.66455. PMID 20644273.
  4. Wrede, B.; Hasselblatt, M.; Peters, O.; Thall, PF.; Kutluk, T.; Moghrabi, A.; Mahajan, A.; Rutkowski, S. et al. (Dec 2009). "Atypical choroid plexus papilloma: clinical experience in the CPT-SIOP-2000 study.". J Neurooncol 95 (3): 383-92. doi:10.1007/s11060-009-9936-y. PMID 19543851.