Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review

Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magn...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Zhang, Xiu-Peng [verfasserIn] Liu, Yang Zhang, Di Zheng, Qin Wang, Chen Wang, Liang Li, Qing-Chang Qiu, Xue-Shan Wang, En-Hua

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Clear-cell ependymoma Tanycytic ependymoma Hemangioblastoma Cerebellum Epithelial membrane antigen Case report

Anmerkung:	© The Author(s). 2017

Übergeordnetes Werk:	Enthalten in: Diagnostic pathology - [S.l.] : BioMed Central, 2006, 12(2017), 1 vom: 20. März
Übergeordnetes Werk:	volume:12 ; year:2017 ; number:1 ; day:20 ; month:03

Links:	Volltext

DOI / URN:	10.1186/s13000-017-0619-2

Katalog-ID:	SPR029379687

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520			\|a Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation.
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allfields	10.1186/s13000-017-0619-2 doi (DE-627)SPR029379687 (SPR)s13000-017-0619-2-e DE-627 ger DE-627 rakwb eng Zhang, Xiu-Peng verfasserin aut Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Liu, Yang (orcid)0000-0002-6033-0648 aut Zhang, Di aut Zheng, Qin aut Wang, Chen aut Wang, Liang aut Li, Qing-Chang aut Qiu, Xue-Shan aut Wang, En-Hua aut Enthalten in Diagnostic pathology [S.l.] : BioMed Central, 2006 12(2017), 1 vom: 20. März (DE-627)503328960 (DE-600)2210518-9 1746-1596 nnns volume:12 year:2017 number:1 day:20 month:03 https://dx.doi.org/10.1186/s13000-017-0619-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_168 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2017 1 20 03
spelling	10.1186/s13000-017-0619-2 doi (DE-627)SPR029379687 (SPR)s13000-017-0619-2-e DE-627 ger DE-627 rakwb eng Zhang, Xiu-Peng verfasserin aut Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Liu, Yang (orcid)0000-0002-6033-0648 aut Zhang, Di aut Zheng, Qin aut Wang, Chen aut Wang, Liang aut Li, Qing-Chang aut Qiu, Xue-Shan aut Wang, En-Hua aut Enthalten in Diagnostic pathology [S.l.] : BioMed Central, 2006 12(2017), 1 vom: 20. März (DE-627)503328960 (DE-600)2210518-9 1746-1596 nnns volume:12 year:2017 number:1 day:20 month:03 https://dx.doi.org/10.1186/s13000-017-0619-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_168 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2017 1 20 03
allfields_unstemmed	10.1186/s13000-017-0619-2 doi (DE-627)SPR029379687 (SPR)s13000-017-0619-2-e DE-627 ger DE-627 rakwb eng Zhang, Xiu-Peng verfasserin aut Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Liu, Yang (orcid)0000-0002-6033-0648 aut Zhang, Di aut Zheng, Qin aut Wang, Chen aut Wang, Liang aut Li, Qing-Chang aut Qiu, Xue-Shan aut Wang, En-Hua aut Enthalten in Diagnostic pathology [S.l.] : BioMed Central, 2006 12(2017), 1 vom: 20. März (DE-627)503328960 (DE-600)2210518-9 1746-1596 nnns volume:12 year:2017 number:1 day:20 month:03 https://dx.doi.org/10.1186/s13000-017-0619-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_168 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2017 1 20 03
allfieldsGer	10.1186/s13000-017-0619-2 doi (DE-627)SPR029379687 (SPR)s13000-017-0619-2-e DE-627 ger DE-627 rakwb eng Zhang, Xiu-Peng verfasserin aut Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Liu, Yang (orcid)0000-0002-6033-0648 aut Zhang, Di aut Zheng, Qin aut Wang, Chen aut Wang, Liang aut Li, Qing-Chang aut Qiu, Xue-Shan aut Wang, En-Hua aut Enthalten in Diagnostic pathology [S.l.] : BioMed Central, 2006 12(2017), 1 vom: 20. März (DE-627)503328960 (DE-600)2210518-9 1746-1596 nnns volume:12 year:2017 number:1 day:20 month:03 https://dx.doi.org/10.1186/s13000-017-0619-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_168 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2017 1 20 03
allfieldsSound	10.1186/s13000-017-0619-2 doi (DE-627)SPR029379687 (SPR)s13000-017-0619-2-e DE-627 ger DE-627 rakwb eng Zhang, Xiu-Peng verfasserin aut Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2017 Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213 Liu, Yang (orcid)0000-0002-6033-0648 aut Zhang, Di aut Zheng, Qin aut Wang, Chen aut Wang, Liang aut Li, Qing-Chang aut Qiu, Xue-Shan aut Wang, En-Hua aut Enthalten in Diagnostic pathology [S.l.] : BioMed Central, 2006 12(2017), 1 vom: 20. März (DE-627)503328960 (DE-600)2210518-9 1746-1596 nnns volume:12 year:2017 number:1 day:20 month:03 https://dx.doi.org/10.1186/s13000-017-0619-2 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_168 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 12 2017 1 20 03
language	English
source	Enthalten in Diagnostic pathology 12(2017), 1 vom: 20. März volume:12 year:2017 number:1 day:20 month:03
sourceStr	Enthalten in Diagnostic pathology 12(2017), 1 vom: 20. März volume:12 year:2017 number:1 day:20 month:03
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Clear-cell ependymoma Tanycytic ependymoma Hemangioblastoma Cerebellum Epithelial membrane antigen Case report
isfreeaccess_bool	true
container_title	Diagnostic pathology
authorswithroles_txt_mv	Zhang, Xiu-Peng @@aut@@ Liu, Yang @@aut@@ Zhang, Di @@aut@@ Zheng, Qin @@aut@@ Wang, Chen @@aut@@ Wang, Liang @@aut@@ Li, Qing-Chang @@aut@@ Qiu, Xue-Shan @@aut@@ Wang, En-Hua @@aut@@
publishDateDaySort_date	2017-03-20T00:00:00Z
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spellingShingle	Zhang, Xiu-Peng misc Clear-cell ependymoma misc Tanycytic ependymoma misc Hemangioblastoma misc Cerebellum misc Epithelial membrane antigen misc Case report Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
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topic_title	Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review Clear-cell ependymoma (dpeaa)DE-He213 Tanycytic ependymoma (dpeaa)DE-He213 Hemangioblastoma (dpeaa)DE-He213 Cerebellum (dpeaa)DE-He213 Epithelial membrane antigen (dpeaa)DE-He213 Case report (dpeaa)DE-He213
topic	misc Clear-cell ependymoma misc Tanycytic ependymoma misc Hemangioblastoma misc Cerebellum misc Epithelial membrane antigen misc Case report
topic_unstemmed	misc Clear-cell ependymoma misc Tanycytic ependymoma misc Hemangioblastoma misc Cerebellum misc Epithelial membrane antigen misc Case report
topic_browse	misc Clear-cell ependymoma misc Tanycytic ependymoma misc Hemangioblastoma misc Cerebellum misc Epithelial membrane antigen misc Case report
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title	Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
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title_full	Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
author_sort	Zhang, Xiu-Peng
journal	Diagnostic pathology
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author_browse	Zhang, Xiu-Peng Liu, Yang Zhang, Di Zheng, Qin Wang, Chen Wang, Liang Li, Qing-Chang Qiu, Xue-Shan Wang, En-Hua
container_volume	12
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author-letter	Zhang, Xiu-Peng
doi_str_mv	10.1186/s13000-017-0619-2
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title_sort	cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
title_auth	Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
abstract	Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. © The Author(s). 2017
abstractGer	Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. © The Author(s). 2017
abstract_unstemmed	Background Imaging and histology of clear-cell ependymoma and cerebellum-based hemangioblastoma are similar; distinguishing between them is a diagnostic challenge. Case presentation A 62-year-old Chinese woman presented with an intermittent headache of 8 years’ duration. Computed tomography and magnetic resonance imaging revealed a mass in the cerebellum. Neurological imaging suggested hemangioblastoma (HB). Histologically, the tumor included cellular and paucicellular areas, in which cells were arranged in nests or diffusely distributed; and a highly vascular area, in which tumor cells were arranged in clusters and separated by capillaries. At low magnification, the tumor mimicked cellular HB, but at high magnification, tumor cells showed clear cytoplasm instead of the vacuolated cytoplasm typically observed in HB. Moreover, spindly, bipolar elements resembling tanycytes were observed within the nest structures. Although these features indicated the possibility of ependymoma, neither true ependymal rosettes nor an ependymal-lined profile was observed. The tumor was characterized by prominent vascularity, but glomeruloid formation was absent. We saw pleomorphism in foci of some tumor giant cells, but pathologic mitosis and palisaded necrosis were absent. Most tumor cells were positive for glial fibrillary acidic protein and S100. Epithelial membrane antigen was expressed with a paranuclear dot-like or a ring-like pattern. The Ki-67 index was approximately 2%. Considering the patient’s symptom, neurological imaging, and pathological findings, she was diagnosed as cerebellar ependymoma (WHO grade II). Conclusions Here, we report a case of ependymoma with overlapping clear-cell and tanycytic features, and review the literature to evaluate its real incidence. Pathologists should consider this rare diagnosis when confronted with a similar presentation. © The Author(s). 2017
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title_short	Cerebellar ependymoma with overlapping features of clear-cell and tanycytic variants mimicking hemangioblastoma: a case report and literature review
url	https://dx.doi.org/10.1186/s13000-017-0619-2
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author2	Liu, Yang Zhang, Di Zheng, Qin Wang, Chen Wang, Liang Li, Qing-Chang Qiu, Xue-Shan Wang, En-Hua
author2Str	Liu, Yang Zhang, Di Zheng, Qin Wang, Chen Wang, Liang Li, Qing-Chang Qiu, Xue-Shan Wang, En-Hua
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