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Published on: November 11, 2021
Cytologic findings in malignant ependymoma: a case report
Negar Azarpira1, Mohammad Rakei, Maral Mokhtari
1Department of Pathology, Transplant Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. negarazarpira@yahoo.com
Acta Cytologica
|November 9, 2010
Summary
Intraoperative imprint cytology aids in diagnosing central nervous system (CNS) tumors like ependymomas. Immunohistochemistry is crucial for definitive diagnosis due to variable cytomorphology in anaplastic ependymoma.
Area of Science:
- Neuropathology
- Cytopathology
Background:
- Intraoperative imprint cytology is valuable for diagnosing central nervous system (CNS) tumors.
- Ependymomas are rare glial neoplasms originating from the ependymal lining.
- Anaplastic ependymoma presents diagnostic challenges in imprint cytology due to variable cytomorphology.
Observation:
- A 21-year-old female presented with headache and vomiting, indicative of hydrocephalus and a parietal lobe tumor.
- Intraoperative cytology revealed a hypercellular smear with small cells, scant cytoplasm, and high nucleus-to-cytoplasm ratios.
- Tumor cells exhibited pseudorosettes and expressed glial fibrillary acidic protein (GFAP) and epithelial membrane antigen (EMA).
Findings:
- Imprint cytology demonstrated features suggestive of ependymoma, including pseudorosettes.
- Histologic and immunologic confirmation were essential for the final diagnosis.
- Immunohistochemical markers (GFAP, EMA) supported the diagnosis of ependymoma.
Implications:
- Imprint cytology provides rapid intraoperative diagnostic information for CNS tumors.
- Immunohistochemistry is critical for accurate classification and definitive diagnosis of challenging cases like anaplastic ependymoma.
- This case highlights the complementary roles of cytology and immunohistochemistry in neuro-oncology.
