Hemangioblastoma - spinal cord

Discussion:

The patient went on to have a biopsy. At surgery, the dura was opened and the cord resembled a vascular malformation with many very prominent vessels.

Histology

Sections show a well-circumscribed tumor composed of abundant small thin-walled capillary sized blood vessels. The intervening stroma contains stellate cells with "bubbly" vacuolated cytoplasm. There is no necrosis, mitoses or atypia seen.

Immunohistochemical results show stromal cells stain: Inhibin+, 8100+ and CAM5.2-; consistent with hemangioblastoma.

FINAL DIAGNOSIS: hemangioblastoma (WHO Grade I).

Discussion

The spinal cord, due to its morphology, constrains pathology to a ~10-20 mm cylinder. As such the morphology of lesions is less helpful than in the brain. In this case, the prominent vessels are very helpful in suggesting the diagnosis. 

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