Difference between revisions of "Myxopapillary ependymoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Myxopapillary_ependymoma_-_very_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = Myxopapillary ependymoma. [[ | | Caption = Myxopapillary ependymoma. [[HPS stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = Papillary tumor cells around vascular myxoid matrix | | Micro = Papillary tumor cells around vascular myxoid matrix | ||
| Subtypes = | | Subtypes = subtype of [[ependymoma]] | ||
| LMDDx = [[ | | LMDDx = [[chordoma]], [[myxoid chondrosarcoma]], [[paraganglioma]], papillary [[adenocarcinoma]] | ||
| Stains = Alcian blue +ve | | Stains = Alcian blue +ve | ||
| IHC = GFAP +ve | | IHC = GFAP +ve | ||
| Line 30: | Line 30: | ||
| Tx = | | Tx = | ||
}} | }} | ||
'''Mxyopapillary Ependymoma''', is a low-grade [[Ependymoma]]. It is nearly always associated with [[cauda equina]] and [[filum terminale]]. | '''Mxyopapillary Ependymoma''', is a low-grade [[Ependymoma]]. It is nearly always associated with [[cauda equina]] and [[filum terminale]]. | ||
==General== | ==General== | ||
*Low-grade [[ | *Low-grade [[ependymoma]] - ''WHO Grade I'' by definition. | ||
*Classically in the spinal cord of adults. | *Classically in the spinal cord of adults. | ||
* Approx 9-13% of all ependymal tumors.<ref>{{Cite journal | last1 = Schiffer | first1 = D. | last2 = Chiò | first2 = A. | last3 = Giordana | first3 = MT. | last4 = Migheli | first4 = A. | last5 = Palma | first5 = L. | last6 = Pollo | first6 = B. | last7 = Soffietti | first7 = R. | last8 = Tribolo | first8 = A. | title = Histologic prognostic factors in ependymoma. | journal = Childs Nerv Syst | volume = 7 | issue = 4 | pages = 177-82 | month = Aug | year = 1991 | doi = | PMID = 1933913 }}</ref> | * Approx 9-13% of all ependymal tumors.<ref>{{Cite journal | last1 = Schiffer | first1 = D. | last2 = Chiò | first2 = A. | last3 = Giordana | first3 = MT. | last4 = Migheli | first4 = A. | last5 = Palma | first5 = L. | last6 = Pollo | first6 = B. | last7 = Soffietti | first7 = R. | last8 = Tribolo | first8 = A. | title = Histologic prognostic factors in ependymoma. | journal = Childs Nerv Syst | volume = 7 | issue = 4 | pages = 177-82 | month = Aug | year = 1991 | doi = | PMID = 1933913 }}</ref> | ||
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==Gross== | ==Gross== | ||
* | *Soft. | ||
* | *Gray. | ||
* | *Discrete masses. | ||
* | *Often encapsulated. | ||
*Subtotal resected tumors may spread throughout the neuraxis. | *Subtotal resected tumors may spread throughout the neuraxis. | ||
| Line 52: | Line 51: | ||
</gallery> | </gallery> | ||
== | ==Microscopic== | ||
Features: | Features: | ||
*Papillary appearance. | *Papillary appearance. | ||
| Line 61: | Line 60: | ||
*Microcysts. | *Microcysts. | ||
*Low mitotic activity. | *Low mitotic activity. | ||
Note: | Note: | ||
| Line 67: | Line 65: | ||
DDx: | DDx: | ||
* [[Chordoma]] | * [[Chordoma]]. | ||
* [[Myxoid chondrosarcoma]] | * [[Myxoid chondrosarcoma]]. | ||
* [[Paraganglioma]] | * [[Paraganglioma]]. | ||
* Papillary [[ | * Papillary [[adenocarcinoma]]. | ||
===Images=== | |||
<gallery> | <gallery> | ||
File:Myxopapillary_ependymoma.jpg | Mxyopapillary Ependymoma, HE Smear (AFIP) | File:Myxopapillary_ependymoma.jpg | Mxyopapillary Ependymoma, HE Smear (AFIP) | ||
File:Myxopapillary_ependymoma_-_intermed_mag.jpg | Mxyopapillary Ependymoma, low magnification (WC/Nephron) | File:Myxopapillary_ependymoma_-_intermed_mag.jpg | Mxyopapillary Ependymoma, low magnification (WC/Nephron) | ||
File:Myxopapillary_ependymoma-HE.jpg | Intermediate magnification (WC/jensflorian | File:Myxopapillary_ependymoma-HE.jpg | Intermediate magnification (WC/jensflorian) | ||
File:Myxopapillary_ependymoma_-_very_high_mag.jpg | High magnification (WC/Nephron) | File:Myxopapillary_ependymoma_-_very_high_mag.jpg | High magnification (WC/Nephron) | ||
File:Myxopapillary_ependymoma_HE_x40.jpg | Mxyopapillary Ependymoma, vascular sclerosis (WC/jensflorian) | File:Myxopapillary_ependymoma_HE_x40.jpg | Mxyopapillary Ependymoma, vascular sclerosis (WC/jensflorian) | ||
| Line 92: | Line 90: | ||
==Molecular== | ==Molecular== | ||
* Poorly characterized | * Poorly characterized. | ||
* No consistent abberations. | * No consistent abberations. | ||
==See also== | ==See also== | ||
Latest revision as of 04:11, 2 May 2015
| Myxopapillary ependymoma | |
|---|---|
| Diagnosis in short | |
 Myxopapillary ependymoma. HPS stain. | |
|
| |
| LM | Papillary tumor cells around vascular myxoid matrix |
| Subtypes | subtype of ependymoma |
| LM DDx | chordoma, myxoid chondrosarcoma, paraganglioma, papillary adenocarcinoma |
| Stains | Alcian blue +ve |
| IHC | GFAP +ve |
| Site | usually lumbar spinal cord |
|
| |
| 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)
Microscopic
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:
- Chordoma.
- Myxoid chondrosarcoma.
- Paraganglioma.
- Papillary adenocarcinoma.
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.