Chordoid glioma in suprasellar location with extension into the third ventricle: Smear preparation morphology of a rare tumor

Abstract

We report a rare case of recurrent chordoid glioma in suprasellar region with extension into the third ventricle diagnosed peroperatively. On MRI, a brilliantly contrast enhancing lesion in the suprasellar region extending superiorly into the third ventricle and measuring 2.5 × 3 × 3.5 cm was identified. Patient had a previous history of subtotal removal of the tumor 8 months back and had received 56 Gy of postoperative radiotherapy. On smear preparation the tumor was composed of cells arranged in chords and rows in a myxoid background with sprinkling of lymphocytes. The individual cells were polygonal with moderate amount of faintly eosinophilic cytoplasm with cytoplasmic vacoules in few cells. The nuclei showed fine chromatin with small prominent nucleoli. Paraffin sections confirmed the diagnosis and on immunohistochemistry the tumor cells showed strong positivity for GFAP and focal weak positivity for EMA with low MIB-1 labeling index (<1%). To the best of our knowledge this is the first documented case of chordoid glioma described on crush cytology.

Chordoid glioma: a rare radiologically, histologically, and clinically mystifying lesion

“…A widespread knowledge of this newly defined third ventricle pathological entity in the radiologists’ community appears to be mandatory. As for histological examination, recent publications report that intraoperative smear cytology could reveal distinctive cytological features, identifying the unique histological pattern of chordoid gliomas [ 14 , 20 ]. In literature, we found that the main problem lied in telling a chordoid glioma from a chordoid meningioma.…”

Cytological features of chordoid glioma: A case report with summary of prior published cases

“…A brief summary of these cases is listed in the Table 1. [3][4][5] In all the three cases the smears were cellular. The cellularity is generally high and it can be mistaken for high grade glioma.…”

Pituicytoma with pleomorphism: A case report with cytological findings

“…On crush cytology, epithelioid cells with eosinophilic, polygonal to spindle cytoplasm appear as sheets or solid clusters, with mucinous background. 11,12 It seems helpful that choroid glioma is positive for CD34. 4 Granular cell tumor of the sellar region and spindle cell oncocytoma are also included in differential diagnosis.…”

“…As for rare tumors, chordoid glioma occurring in the third ventricle might have to be distinguished, because it is positive for TTF‐1, GFAP, and vimentin. On crush cytology, epithelioid cells with eosinophilic, polygonal to spindle cytoplasm appear as sheets or solid clusters, with mucinous background 11,12 . It seems helpful that choroid glioma is positive for CD34 4 .…”