少突星形细胞瘤

间变室管膜瘤

 

There are necrosis and vascular proliferation in this mitotically active neoplasm. In a young child's right thalamus,such histopathology generates the differential diagnoses of anaplastic ependymoma (WHO grade III), supratentorial PNET (WHO grade IV), and atypical teratoid/rhabdoid tumor (AT/RT, WHO grade IV). I do not see formation of Homer-Wright or neuroblastic rosettes to support PNET. Instead, perivascular arrangement and cells with clear cytoplasm are seen. These findings would favor anaplastic ependymoma, but immunohistochemistry needs to be done to be sure (GFAP, NSE, synaptophysin, EMA, smooth muscle-specific actin, AE1).

赏心悦目的图片，菊形团、坏死、血管内皮增生、核分裂、少突胶质细胞样细胞。

翻译mjma老师贴子：核分裂活跃的肿瘤往往有坏死、血管增生。发生在儿童右丘脑，这样的组织学表现要鉴别WHOIII级的间变性室管膜瘤、WHOIV级的幕上PNET以及WHOIV级的非典型畸胎样/横纹肌样瘤。本例见细胞血管周排列，细胞浆透亮，未见Homer－Wright或神经母细胞瘤样菊形团，不支持PNET，支持间变性室管膜瘤。但需免疫组化（GFAP、NSE、syn、EMA、SMA、AE1）证实。

 室管膜母细胞瘤

 PNET

间变性室管膜瘤

 

 间变室管膜瘤

 间变性室管膜瘤