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Path Quiz Case4: Diagnosis- |
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August 2009
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Path
Quiz Case 4:Case
history and images
Myxopapillary ependymoma is a distinctive variant of ependymoma which was first described as a separate pathological entity by Kernohan JW (Primary tumours of the spinal cord and intradural filum terminale - Cytology and cellular pathology of the nervous system. Vol 3 , 1932: 993-1025). These tumours are usually restricted to the conus medullaris and filum terminale. These tumours originate from extramedullary ependymal rests representing
remnants of the coccygeal medullary vestige , an ependyma lined cleft , and
is a derivative of the caudal neural tube persisting beneath the skin of
the postanal pit . Clinically, this lesion is
often misdiagnosed as a pilonidal sinus or cyst. The differential
diagnosis also includes sacrococcygeal teratoma, neurogenic tumour, soft
tissue sarcoma and metastatic carcinoma. When the tumour involves sacrum
and coccyx , tumours such as chordoma and chondrosarcoma must also be
excluded.
Image
Link1
Histologically the differential diagnosis includes
chordoma
and
schwannoma. Immunopositivity of the tumour cells with GFAP helps in
confirming the diagnosis of myxopapillary ependymoma.
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