Ependymoma

Case contributed by RMH Neuropathology

Presentation

No data available.

Patient Data

Age: 51-year-old
Gender: Female

MRI Brain

Modality: MRI

Technique: Multiplanar and multisequence images have been obtained through the brain, including MR spectroscopy, MR perfusion, and stereotaxic protocol.

Findings: A 3cm (CC) x 2.3cm (AP) x 1.7cm (trans) enhancing lesion arises from the inferior 4th ventricle, distorting the medulla and displacing it anteriorly. No hydrocephalus. Rare and sparse chronic small vessel ischaemic white matter changes are present, in a number acceptable for the age group. The remainder brain is unremarkable.

Conclusion: 4th ventricle mass which may correspond to an ependymoma or a choroid plexus papilloma. 

Modality: Pathology

MICROSCOPIC DESCRIPTION: The sections show fragments of a moderately hypercellular ependymoma. Tumour cells have mildly pleomorphic vesicular nuclei with a finely granular chromatin. Well formed perivascular pseudorosettes are noted throughout all fragments submitted. Annotated Figure 1: A) tumour cells B) 'clear area' and C) central vessel. 

A very occasional mitotic figure is identified (1/20 HPF). There is no microvascular proliferation. Two small areas of bland infarct-like necrosis are noted.

Immunohistochemistry shows prominent perinuclear dot staining for epithelial membrane antigen (EMA) in tumour cells as well as strong staining for GFAP. The topoisomerase labelling index is approximately 10%.

DIAGNOSIS: Brain tumour: Ependymoma (WHO Grade II).

Case Discussion

This patient had also his entire spine screened with MRI, no other lesions (seeding) were found. 

Ependymomas represent a relatively broad group of glial tumours which share a common origin from differentiated ependymal cells lining the ventricles of the brain or the central canal of the spinal cord.

PlayAdd to Share

Case Information

rID: 41310
Case created: 25th Nov 2015
Last edited: 6th Mar 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.