Pineal parenchymal tumour with intermediate differentiation

A.Prof Frank Gaillard et al.

Pineal parenchymal tumours with intermediate differentiation (PPTID) are, as the name suggests, tumours which fall between pineocytoma (well differentiated, WHO grade I) and pineoblastomas (poorly differentiated, WHO grade IV) and are considered WHO grade II / III tumours 2. This is a tumour encountered at all ages, but particularly of middle age adults (20-70 years of age) with slight female predilection, similar to that of pineocytomas 4

Their radiographic appearance and biological behaviour are also intermediate. They may invade adjacent structures and also spread along CSF (imaging of the intire craniospinal axis is required 3).


Macroscopic appearance

Pineal parenchymal tumour with intermediate differentiation have similar macroscopic appearance to pineocytomas, appearing relatively well circumscribed with heterogeneous cut surface 4.

Microscopic appearance

Two microscopic patterns are encountered, sometimes co-existing 4:

  1. lobulated
  2. diffuse

The lobulated pattern, poorly defined lobules are separated from each other by large fibrous vessels 4.

The diffuse pattern is reminiscent to oligodendrogliomas and/or central neurocytomas, with the large pineocytomatous rosettes characteristic of pineocytomas not evident 4.



Pineal region masses

The pineal region is anatomically complex and plays host to a number of unique masses and tumours as well as potentially affected by many entities seen more frequently elsewhere in the brain. 

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Article information

rID: 6514
Section: Pathology
Tag: cases
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