ependymoma


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  • Clinical

    • site: ventricles, spinal cord
      • infratentorial = children
      • spinal cord = adult
      • supratentorial = both
    • prognosis
      • best: spinal
      • better: supratentorial
      • worst: posterior fossa
    • WHO grade II

  • Histology

    • perivascular pseudorosettes, ependymal rosettes (less frequent)
    • monomorphic blue cells
      • moderate cellularity
      • salt and pepper chromatin
      • absent/rare mitosis
    • stroma can have areas that are fibrillary, necrotic
    • can have regressive changes (myxoid, hemorrhage, calcifications, cartilage, bone)

  • Variants

    • cellular ependymoma: more commonly extraventricular
    • papillary ependymoma: smooth linear projections
    • clear cell ependymoma: more commonly supratentorial in young pt, looks like oligo
    • tanycytic ependymoma: most commonly in spinal cord, fascicles, spindle cells

  • Stains

    • positive: GFAP, S100
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