Department of Pathology, University of Oklahoma Health Sciences Center

NeuroTest Question  #83 Next question Previous question

Answer: Myxopapillary ependymoma. Level of difficulty: 3 NeuroTest NeuroLearn NeuroHelp

Discussion: 

• In this cytologic preparation, the salient features are balls of basophilic, mucoid balls (Þ) that are reminiscent of "jello-balls". The tumor cells are rather monotonous and bland in morphology. Long threads of cytoplasm are present and suggest a glial lineage. Interestingly, the tumor cells appear to arrange in the form of a shell around the "jello-balls" (delineated by Þ). These features are diagnostic for myxopapillary ependymoma.  [Click here to see a case of myxopapillary ependymoma]
• In metastatic mucin producing adenomcarcinoma, the mucin typically occur as a smear on cytologic preparations. The cell borders are well defined and often contain cytoplasmic vacuoles. The nuclei are more atypical and have prominent nucleoli.
• Low-grade astrocytomas may have similar cytologic features. Metachromatic mucoid material is a common finding and typically occur as a faint smear with blurred margin in cytologic preparation. The mucoid material would not appear as "jello-balls" as illustrated in this photomicrograph.
• Chordoma also have chondroid materials that appear as "jello-balls". However, chordoma cells do not have long cytoplasmic processes as in glial tumors. Instead, they often occurs polygonal cells, with bubbly cytoplasm and well defined cell border (physaliphorous cells). [Low-magnification of physaliphorous cells in chordoma] [High-magnification of physaliphorous cells in chordoma]

Comment: KarMing-Fung@ouhsc.edu