Myxopapillary ependymoma

{{ Infobox diagnosis | Name = Myxopapillary ependymoma | Image = File:Myxopapillary_ependymoma_-_very_high_mag.jpg | Width = | Caption = Myxopapillary ependymoma. H&E stain | Synonyms = | Micro = Papillary tumor cells around vascular myxoid matrix | Subtypes = | LMDDx = [[Ependymoma] | Stains = Alcian blue +ve | IHC = GFAP +ve | EM = | Molecular = | IF = | Gross = | Grossing = | Site = usually lumbar spinal cord | Assdx = | Syndromes = | Clinicalhx = | Signs = | Symptoms = | Prevalence = | Bloodwork = | Rads = | Endoscopy = | Prognosis = good (WHO Grade I) | Other = | ClinDDx = | Tx = }}

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.
• 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)

Histology

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.

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

• Neuropathology tumours.
• Ependymoma.