Ependymoma classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]
Overview
Ependymoma may be classified according to the WHO into 3 grades: grades I, II, and III.[1]
Classification
In the most recent World Health Organization (WHO) classification of brain tumors, ependymal tumors are classified into the following four main subtypes:[2][3]
- Subependymoma (WHO Grade I): A subependymoma is a slow-growing neoplasm, typically attached to the ventricle wall and is composed of glial tumor cell clusters embedded in a fibrillary matrix.
- Myxopapillary ependymoma (WHO Grade I): A myxopapillary ependymoma arises almost exclusively in the location of the conus medullaris, cauda equina, and filum terminale of the spinal cord and is characterized histologically by tumor cells arranged in a papillary manner around vascularized myxoid stromal cores.
- Ependymoma (WHO Grade II): The ependymoma, which is considered a Grade II neoplasm originating from the walls of the ventricles or from the spinal canal, is composed of neoplastic ependymal cells. Ependymomas are subdivided, based on histological findings, into the following four subtypes:
- Cellular ependymoma: the most common subtype, this subtype usually demonstrates significant cellularity without an increase in mitotic activity.
- Papillary ependymoma: forms linear, epithelial-like surfaces along cerebrospinal fluid exposures.
- Clear cell ependymoma: displays an oligodendroglial-like appearance with perinuclear halos, this variant is preferentially located in the supratentorial compartment of the brain.
- Tanycytic ependymoma: the rarest form of Grade II ependymoma, this subtype is most commonly found in the spinal cord; tumor cells are arranged in fascicles of variable width and cell density and are poorly intertwined.
- Anaplastic ependymoma (WHO Grade III): Also known as malignant ependymoma. An anaplastic ependymoma is considered a malignant glioma of ependymal differentiation and, compared with the Grade II ependymomas, shows increased cellularity and increased mitotic activity, often associated with microvascular proliferation and necrosis.
Ependymal tuomrs are also classified based on their sites of origin into:[4][3]
- Supratentorial ependymomas
- Infratentorial ependymomas
- Spinal cord ependymomas
References
- ↑ .Ependymomas Dr Bruno Di Muzio and Dr Frank Gaillard Gold Supporter since June 24, 2015">. Radiopaedia.org 2015.http://radiopaedia.org/articles/ependymoma
- ↑ Louis DN, Ohgaki H, Wiestler OD, et al., eds.: WHO Classification of Tumours of the Central Nervous System. 4th ed. Lyon, France: IARC Press, 2007.
- ↑ 3.0 3.1 Eoendymoma. http://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq#section/_35 URL Accessed on 10 6 2015.
- ↑ Fairman K, Giacobini E, Chiappinelli V (1976). "Developmental variations of tyrosine hydroxylase and acetylcholinesterase in embryonic and post-hatching chicken sympathetic ganglia". Brain Res. 102 (2): 301–12. PMID 2367-71 Check
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