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Myxopapillary ependymoma: Lesser known cytomorphologic features
Monisha Choudhury1, Archna Rautela1, Manupriya Nain1
1Department of Pathology, Lady Hardinge Medical College, New Delhi, India.
Abstract:
Myxopapillary ependymoma (MPE) is a rare and distinctive tumor which occurs in the sacrococcygeal area of young adults and children, often intradural in location. Histopathologic features have been well-described in the literature whereas cytological findings have been sporadically reported by various authors mainly as case reports. We report the features of a primary sacrococcygeal MPE on aspirate cytology in a 45-year-old female. Cytology smears displayed a papillary pattern with the presence of fibrovascular cores, rimmed by cuboidal to columnar cells sending fibrillary cytoplasmic processes forming pseudorosettes along with the presence of hyaline globules, and myxoid material. Intranuclear inclusions, nuclear grooves, cytologic atypia or mitotic activity was not evident, in this case. MPEs need to be differentiated from the other tumors occurring in this location which may also show myxoid material and papillary fronds. Hence, the recognition of the characteristic cytologic features plays an important role in establishing a preoperative diagnosis.
Insights
This case report details the cytologic features of a sacrococgeal myxopapillary ependymoma (MPE) in an adult. Recognizing these distinct MPE findings aids in preoperative diagnosis and differentiation from other spinal tumors.
Area of Science:
- Neuropathology
- Cytopathology
Background:
- Myxopapillary ependymoma (MPE) is a rare tumor typically affecting the sacrococcygeal region in pediatric and young adult populations.
- While histopathologic features are well-documented, cytological findings of MPE are less frequently reported, often in case studies.
Observation:
- This study presents the aspirate cytology of a primary sacrococcygeal MPE in a 45-year-old female.
- Cytological smears revealed a papillary architecture with fibrovascular cores, cuboidal to columnar cells forming pseudorosettes, fibrillary cytoplasmic processes, hyaline globules, and myxoid material.
Findings:
- Key diagnostic features included the characteristic papillary pattern and cellular morphology.
- Absence of intranuclear inclusions, nuclear grooves, cytologic atypia, or mitotic activity was noted in this specific case.
- The presence of myxoid material and papillary structures necessitates differentiation from other tumors in the sacrococcygeal region.
Implications:
- Accurate recognition of MPE's cytologic features is crucial for establishing a preoperative diagnosis.
- This case contributes to the understanding of MPE cytopathology, particularly in adult patients.
- Distinguishing MPE from other myxoid and papillary tumors in this location is vital for appropriate patient management.
