Central neurocytoma

Case contributed by RMH Neuropathology

Presentation

Patient referred for evaluation of a intraventricular tumour.

Patient Data

Age: 18
Gender: Female
MRI

MRI Brain

A large mass of heterogeneous signal and enhancement is seen within the frontal horn of the left lateral ventricle. The septum pellucidum is bowed to the left. The mass abuts the head of the caudate nucleus. There is obstructive hydrocephalus evident with transependymal spread on the right. Overall dimensions of the mass are 37.5 millimetres SI, 35 mm transverse and 36 mm AP. There is raised mild pulsatile and minimally increased choline within the mass. There is elevated cerebral blood volume (CBV) within the lesion.

Conclusion:

Findings compatible with a central neurocytoma.

Pathology

MACROSCOPIC DESCRIPTION:

1. "Brain tissue": Fragments of soft gelatinous tissue up to 3mm. Portion for frozen section/smear. Remaining tissue for formalin plus glutaraldehyde (hold for EM).

2. "Brain tissue": Multiple pieces of soft tan tissue 17x15x3mm in aggregate. A1. 

MICROSCOPIC DESCRIPTION:

1&2. Paraffin sections show a moderately hypercellular tumour. Tumour cells have uniform medium sized round nuclei with granular chromatin and delicate processes and are arranged on lobules and solid sheets in a neuropil-like background. Scattered cells are undergoing apoptosis. No mitotic figures are identified. Small capillaries are prominent throughout the tumour but no multilayering of atypical cells around vessel lumena is seen. There is no necrosis.

Immunohistochemistry shows that tumour cells are positive for synaptophysin and NeuN. GFAP and tyrosinase are negative.

The features are of central neurocytoma (WHO Grade II).

DIAGNOSIS:

"Intraventricular tumour": Central neurocytoma (WHO Grade II).

Case Discussion

Central neurocytomas are WHO Grade II neuroepithelial intraventricular tumours with fairly characteristic imaging features, appearing as heterogeneous masses of variable size and enhancement within the lateral ventricle. They are typically seen in young patients, and generally have a good prognosis provided a complete resection can be achieved. 

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Case information

rID: 37664
Case created: 17th Jun 2015
Last edited: 7th Sep 2015
Inclusion in quiz mode: Included

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