Choroid plexus papilloma

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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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