Document Detail

Ependymomas with neuronal differentiation: a morphologic and immunohistochemical spectrum.
MedLine Citation:
PMID:  17061076     Owner:  NLM     Status:  MEDLINE    
The category of mixed glioneuronal tumors of the CNS is rapidly losing its definition as encompassing tumors composed of histologically distinct neuron variants and glia. We encountered five ependymomas with neuronal differentiation seen in two by histology, in two by immunohistochemistry alone, and in one by electron microscopy. Antibodies against GFAP, S-100 protein, neurofilament protein, chromogranin, synaptophysin, Neu-N, and EMA were applied. Ultrastructural studies were also performed. In addition, 33 randomly selected ependymomas of various histologic types were screened for these same antigens. Cases 1 and 2 were anaplastic and showed clearly defined neuropil islands or pale islands as in nodular desmoplastic medulloblastoma, respectively. The tumors affected a 16-year-old male and a 5-year-old female and involved the right frontoparietal lobe and fourth ventricle, respectively. The islands were positive for synaptophysin and Neu-N (cases 1 and 2), and chromogranin (case 1). Cases 3-5, as well as 7 of the 33 screened ependymomas, showed a suggestion of neuronal differentiation by immunohistochemistry alone, including immunoreactivity for Neu-N (n = 8), synaptophysin (n = 4), neurofilament protein (n = 4), and chromogranin (n = 2). Five tumors each were WHO grade II and III. Electron microscopy performed on the two cases with neuronal islands demonstrated microtubule bundles and dense core granules (case 1) and poorly differentiated cells with high nuclear/cytoplasmic ratios, with intermediate filament accumulation and rare cilia (case 2). Cases identified by immunohistochemistry or electron microscopy demonstrated dense core granules (n = 5) and aligned microtubules (n = 3). Neuronal differentiation occurs in ependymomas but is less frequently definitive (histologic, ultrastructural) than merely a limited immunohistochemical finding. The clinical significance of these observations is unknown but deserves further exploration.
Fausto J Rodriguez; Bernd W Scheithauer; Peter D Robbins; Peter C Burger; Richard B Hessler; Arie Perry; Patrice C Abell-Aleff; Gary W Mierau
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-10-24
Journal Detail:
Title:  Acta neuropathologica     Volume:  113     ISSN:  0001-6322     ISO Abbreviation:  Acta Neuropathol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-10-19     Revised Date:  2007-11-09    
Medline Journal Info:
Nlm Unique ID:  0412041     Medline TA:  Acta Neuropathol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  313-24     Citation Subset:  IM    
Department of Pathology, Mayo Clinic, Rochester, MN, USA.
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MeSH Terms
Cell Differentiation*
Central Nervous System Neoplasms / metabolism*,  pathology*,  physiopathology,  ultrastructure
Child, Preschool
Ependymoma / metabolism,  pathology*,  physiopathology,  ultrastructure
Microscopy, Electron, Transmission
Nerve Tissue Proteins / metabolism
Neurons / physiology*,  ultrastructure
Reg. No./Substance:
0/Nerve Tissue Proteins

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