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Difference between revisions of "Choroid plexus papilloma"
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| Caption = Choroid plexus papilloma [[H&E stain]]. | | Caption = Choroid plexus papilloma [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = papillary epithelial structures with bland cytology, mitoses uncommon | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = metastatic papillary [[adenocarcinoma]], [[ELST]] | | LMDDx = [[choroid plexus carcinoma]], metastatic papillary [[adenocarcinoma]], [[ELST]] | ||
| Stains = | | Stains = | ||
| IHC = Kir 7.1+ve, EAAT1+ve, GFAP+/-, S-100+/-, CK+/- | | IHC = Kir 7.1 +ve, EAAT1 +ve, GFAP +ve/-ve, S-100 +ve/-ve, CK +ve/-ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 15: | Line 15: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = all ventricles, cerebellopontine angle | | Site = all ventricles, [[cerebellopontine angle]] - see ''[[brain tumours]]'' | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = children | ||
| Signs = | | Signs = | ||
| Symptoms = hydrocephalus | | Symptoms = hydrocephalus | ||
| Line 30: | Line 30: | ||
| Tx = | | Tx = | ||
}} | }} | ||
'''Choroid plexus papilloma''', abbreviated '''CPP''', is a benign [[neuropathology]] arising in the ventricles of the brain. | |||
==General== | |||
Features: <ref name=Ref_WHOCNS_82>{{Ref WHOCNS|82}}</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 body|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== | ||
| Line 59: | Line 94: | ||
[[Category:Neuropathology tumours]] | [[Category:Neuropathology tumours]] | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Papillary tumour]] | |||