Central neurocytoma

Case contributed by A.Prof Frank Gaillard
CT

A large intraventricular mass filling and expanding the body of the right lateral ventricle.

MRI

MRI of the brain including post contrast sequences demonstrates a large intraventricular mass filling and expanding the body of the right lateral ventricle. It has high T2 signal, wispy regions of intermediate T1 signal  giving it a bubbly appearance. Following contrast administration only minimal heterogeneous enhancement is present. 

The patient went on to have excision of the intraventricular mass.

Histology 

Microscopic Description:

Sections show a tumor comprised of cells with small round nuclei with stippled neoplasm. Occasional cells have a small nucleolus. Many of the cells have a perinuclear halo and on smears and touch preparations, the cytoplasm is a thin rim of eosinophilia. Within the sheets of tumor cells there are areas where there are delicate eosinophilic processes giving a fibrillar appearance. No mitoses are seen. There are occasional thrombosed vessels associated with hemosiderin deposition. Occasional calcospherites are present.

Immunocytochemistry shows that the tumor is positive for neuron specific enolase and synaptophysin. It is negative for chromogranin and phosphorylated neurofilament. Immunocytochemistry for glial fibrillary acidic protein (GFAP) shows focal areas of positivity; many of the cells with perinuclear halos are negative. Electron microscopy shows that the cells contain dense granules consistent with dense core vesicles.

FINAL DIAGNOSIS: Central neurocytoma.

Case Discussion

This case illustrates typical appearances of a central neurocytoma - a diagnosis which can usually be made with a high degree of certainty pre-operatively. 

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Case information

rID: 4355
Case created: 13th Aug 2008
Last edited: 23rd Jun 2016
Inclusion in quiz mode: Included

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