Ependymoma with “granular cell” features: Report of two cases

We report two cases of ependymoma which showed prominent “granular cell” changes of the cytoplasm. The patients were a 7‐year‐old boy with a tumor in the cerebellum (case 1) and a 70‐year‐old man with a tumor in the frontal lobe (case 2). The tumor of case 1 showed a histopathological appearance of...

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Bibliographic Details
Published in:Neuropathology 2012-12, Vol.32 (6), p.654-661
Main Authors: Shintaku, Masayuki, Yoshida, Makiko, Ikarashi, Toshihiko, Arakawa, Yasuaki, Nagashima, Tatsuya
Format: Article
Language:English
Subjects:
Aged
Brain Neoplasms - diagnosis
Brain Neoplasms - pathology
Brain Neoplasms - ultrastructure
Cerebellum
Cerebellum - pathology
Child
Cytoplasm
ependymoma
Ependymoma - diagnosis
Ependymoma - pathology
Ependymoma - ultrastructure
Frontal lobe
Frontal Lobe - pathology
Glial fibrillary acidic protein
Glial Fibrillary Acidic Protein - metabolism
granular cell
Granules
Humans
immunohistochemistry
Immunohistochemistry - methods
karyotype
Karyotyping - methods
Leukocytes (eosinophilic)
Male
Mitochondria
Mitochondria - ultrastructure
Trisomy
Tumor cells
Tumors
Ubiquitin
ultrastructure
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Summary:We report two cases of ependymoma which showed prominent “granular cell” changes of the cytoplasm. The patients were a 7‐year‐old boy with a tumor in the cerebellum (case 1) and a 70‐year‐old man with a tumor in the frontal lobe (case 2). The tumor of case 1 showed a histopathological appearance of ependymoma containing many focal aggregates of large polygonal cells in which the cytoplasm was stuffed with numerous eosinophilic granules. The tumor of case 2 predominantly showed the features of papillary ependymoma, and some tumor cells were swollen and contained similar eosinophilic granules. Intracytoplasmic granules in both tumors were immunoreactive for GFAP and ubiquitin, but not for epithelial membrane antigen, CD68 or mitochondria. Ultrastructurally, they were found as aggregates of membrane‐bound, electron‐dense, globular structures. Karyotypic analysis of the tumor in case 1 demonstrated 2, 11 and 12 trisomies. Intracytoplasmic eosinophilic granules occasionally occur in astrocytic and oligodendroglial neoplasms, but an appearance of similar granules is very rare in ependymoma. The two cases presented here may represent a new histopathological variant of ependymoma, and the term “granular cell ependymoma” is appropriate for them.
ISSN:0919-6544
1440-1789
DOI:10.1111/j.1440-1789.2012.01298.x