Difference between revisions of "Choroid plexus papilloma"

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'''Choroid plexus papilloma''' is a benign [[neuropathology]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Choroidplexuspapilloma_HE400x.png
| Width      =
| Caption    = Choroid plexus papilloma [[H&E stain]].
| Synonyms  =
| Micro      = papillary epithelial structures with bland cytology, mitoses uncommon
| Subtypes  =
| LMDDx      = [[choroid plexus carcinoma]], metastatic papillary [[adenocarcinoma]], [[ELST]]
| Stains    =
| IHC        = Kir 7.1 +ve, EAAT1 +ve, GFAP +ve/-ve, S-100 +ve/-ve, CK +ve/-ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = all ventricles, [[cerebellopontine angle]] - see ''[[brain tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx = children
| Signs      =
| Symptoms  = hydrocephalus
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Choroid plexus papilloma''', abbreviated '''CPP''', is a benign [[neuropathology]] arising in the ventricles of the brain.


==General==
==General==
*Benign - WHO grade I.<ref name=pmid20644273>{{Cite journal  | last1 = Menon | first1 = G. | last2 = Nair | first2 = SN. | last3 = Baldawa | first3 = SS. | last4 = Rao | first4 = RB. | last5 = Krishnakumar | first5 = KP. | last6 = Gopalakrishnan | first6 = CV. | title = Choroid plexus tumors: an institutional series of 25 patients. | journal = Neurol India | volume = 58 | issue = 3 | pages = 429-35 | month =  | year =  | doi = 10.4103/0028-3886.66455 | PMID = 20644273 |URL = http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2010;volume=58;issue=3;spage=429;epage=435;aulast=Menon }}</ref>
Features: <ref name=Ref_WHOCNS_82>{{Ref WHOCNS|82}}</ref>
*Usu. laternal ventricle in kids.<ref>URL: [http://emedicine.medscape.com/article/250795-overview http://emedicine.medscape.com/article/250795-overview]. Accessed on: 3 June 2011.</ref>
*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 tumours]].
** Approximately 10-20% of all tumours in the first year of life.
** Congenital tumours reported.
*Usually laternal ventricle in children.<ref>URL: [http://emedicine.medscape.com/article/250795-overview http://emedicine.medscape.com/article/250795-overview]. Accessed on: 3 June 2011.</ref>
 
==Gross==
Features: <ref name=Ref_WHOCNS_82>{{Ref WHOCNS|82}}</ref>
* Adhere to ventricular walls.
* Circumscribed.
* Villous architecture.
* 50% lateral ventricles.
* 5% third ventricle.
* 40% fourth ventricle.
* 5% multiple tumours or [[cerebellopontine angle]].


==Microscopic==
==Microscopic==
Features:
Features: <ref name=pmid20644273>{{Cite journal  | last1 = Menon | first1 = G. | last2 = Nair | first2 = SN. | last3 = Baldawa | first3 = SS. | last4 = Rao | first4 = RB. | last5 = Krishnakumar | first5 = KP. | last6 = Gopalakrishnan | first6 = CV. | title = Choroid plexus tumors: an institutional series of 25 patients. | journal = Neurol India | volume = 58 | issue = 3 | pages = 429-35 | month =  | year =  | doi = 10.4103/0028-3886.66455 | PMID = 20644273 |URL = http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2010;volume=58;issue=3;spage=429;epage=435;aulast=Menon }}</ref>
*Simple epithelium.
*Simple epithelium.
*Papillae.
*Papillae.
*Psammoma bodies.
*[[Psammoma body|Psammoma bodies]].
*Rarely [[oncocytoma|oncocytic]] changes, mucinous degeneration.
*[[Necrosis]] and brain invasion is uncommon.
* Atypical CPP: 2 or more mitoses /10 HPF.<ref name=pmid19543851>{{Cite journal  | last1 = Wrede | first1 = B. | last2 = Hasselblatt | first2 = M. | last3 = Peters | first3 = O. | last4 = Thall | first4 = PF. | last5 = Kutluk | first5 = T. | last6 = Moghrabi | first6 = A. | last7 = Mahajan | first7 = A. | last8 = Rutkowski | first8 = S. | last9 = Diez | first9 = B. | title = Atypical choroid plexus papilloma: clinical experience in the CPT-SIOP-2000 study. | journal = J Neurooncol | volume = 95 | issue = 3 | pages = 383-92 | month = Dec | year = 2009 | doi = 10.1007/s11060-009-9936-y | PMID = 19543851 }}</ref>
 
DDx:
*[[Choroid plexus carcinoma]].
*[[Metastatic]] papillary carcinoma.
*[[Endolymphatic sac tumour]] (ELST).


===Images===
===Images===
<gallery>
<gallery>
File:Plexuspapillom_Makroskopie.png | Choroid plexus papilloma can become quite large. (WC/marvin101)
File:Plexuspapilloma_intraoperative_smear.jpg | Intraoperative smear of a choroid plexus papilloma. (WC/jensflorian)
Image:Choroid_plexus_papilloma_micrograph.jpg | Choroid plexus papilloma. (WC)
Image:Choroid_plexus_papilloma_micrograph.jpg | Choroid plexus papilloma. (WC)
File:Atypical CPP Ki67 MIB1.jpg | Elevated proliferative activity (MIB-1) in atypical CPP. (WC/marvin101)
</gallery>
</gallery>
www:
www:
*[http://path.upmc.edu/cases/case551.html Choroid plexus papilloma - oncocytic variant - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case551.html Choroid plexus papilloma - oncocytic variant - several images (upmc.edu)].
==IHC==
*CK7 +ve.
*CK20 -ve (typically).
*S-100 +ve/-ve.
*EMA -ve.
*GFAP +ve/-ve.
*Kir 7.1 +ve.
*EAAT1 +ve.


==See also==
==See also==
*[[Neuropathology tumours]].
*[[Neuropathology tumours]].
*[[Choroid plexus carcinoma]].


==References==
==References==
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[[Category:Neuropathology tumours]]
[[Category:Neuropathology tumours]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Papillary tumour]]

Latest revision as of 02:19, 7 July 2015

Choroid plexus papilloma
Diagnosis in short

Choroid plexus papilloma H&E stain.
LM papillary epithelial structures with bland cytology, mitoses uncommon
LM DDx choroid plexus carcinoma, metastatic papillary adenocarcinoma, ELST
IHC Kir 7.1 +ve, EAAT1 +ve, GFAP +ve/-ve, S-100 +ve/-ve, CK +ve/-ve
Site all ventricles, cerebellopontine angle - see brain tumours
Clinical history children
Symptoms hydrocephalus

Choroid plexus papilloma, abbreviated CPP, 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 tumours.
    • Approximately 10-20% of all tumours in the first year of life.
    • Congenital tumours reported.
  • Usually laternal ventricle in children.[2]

Gross

Features: [1]

  • Adhere to ventricular walls.
  • Circumscribed.
  • Villous architecture.
  • 50% lateral ventricles.
  • 5% third ventricle.
  • 40% fourth ventricle.
  • 5% multiple tumours 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]

DDx:

Images

  • Choroid plexus papilloma can become quite large. (WC/marvin101)

  • Intraoperative smear of a choroid plexus papilloma. (WC/jensflorian)

  • Choroid plexus papilloma. (WC)

  • Elevated proliferative activity (MIB-1) in atypical CPP. (WC/marvin101)

www:

IHC

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

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.
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