Pineal parenchymal tumor of intermediate differentiation with cytologic pleomorphism

Sasaki, Atsushi; Horiguchi, Keishi; Nakazato, Yoichi

doi:10.1111/j.1440-1789.2006.00676.x

Cited by 18 publications

(10 citation statements)

References 17 publications

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“…Except for one young boy, the PC patients were older than 40 years. More than half of the patients with PPTID were younger than 40 years and this tumor seems to be observed in younger patients, in accordance with the previously reported case (20). The male predominance in PC and the female predominance in PPTID remain to be verified with a higher number of cases, as no sex predilection has been reported for PPT (15, 16).…”

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Pineocytoma and Pineal Parenchymal Tumors of Intermediate Differentiation Presenting Cytologic Pleomorphism: A Multicenter Study

Fèvre‐Montange¹,

Szathmari²,

Champier³

et al. 2008

Brain Pathology

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Cytologic pleomorphism has been described in a limited number of benign pineal tumors, namely pineocytoma (PC) and pineal parenchymal tumors (PPTs) of intermediate differentiation (PPTID). We examined the clinicopathologic features in a retrospective series of 14 cases (seven females and seven males aged from 10 to 65 years) of pleomorphic PPT. Seven cases were PC, with no mitoses and with areas of tumoral cells forming large pineocytomatous rosettes and other areas with giant cells containing hyperchromatic nuclei. The other seven were PPTID, presenting few mitoses (< or =2), a Ki67 proliferation index between 3% and 7%, and predominantly composed of small neoplastic cells and scattered giant cells, sometimes multinucleated. In the 14 tumors, the proportion of pleomorphic areas was variable. Most tumoral cells showed extensive neuronal differentiation with strong expression of neuron-specific enolase, synaptophysin and neurofilaments. Some of the neoplastic cells expressed S100 protein. The follow-up period ranged from 1.2 to 13 years and only one PC and one PPTID progressed after stereotactic biopsy or incomplete resection. The lack of invasiveness and the low proliferation index of these tumors suggest a benign clinical course despite the marked pleomorphism, the latter of which can lead to upgrading.

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Section: Discussionsupporting

confidence: 87%

“…In PC, cytologic pleomorphism accompanied by ganglion cells intensely expressing neuronal markers has been described (9,11). Moreover, cytologic pleomorphism has been recently reported in one case of PPTID (20). However, because of the rarity of PPT, these are the only tumors with cytologic pleomorphism reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Pineocytoma and Pineal Parenchymal Tumors of Intermediate Differentiation Presenting Cytologic Pleomorphism: A Multicenter Study

Fèvre‐Montange¹,

Szathmari²,

Champier³

et al. 2008

Brain Pathology

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“…Cellular pleomorphism is often encountered in pineal parenchymal tumors [13, 14], and was the main differential diagnosis in case 1, specifically a “collision tumor” between a PTPR and a pineal parenchymal tumor. However, the almost complete absence of synaptophysin staining, in particular in the pleomorphic areas, which contrasted with adjacent non-neoplastic pineal gland, argues against this possibility.…”

Section: Discussionmentioning

confidence: 99%

Cellular pleomorphism in papillary tumors of the pineal region

et al. 2012

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Papillary tumor of the pineal region (PTPR) is a recently recognized entity. We present the pathologic findings of two cases of PTPR as examples, and discuss the presence of cellular pleomorphism in these tumors. Patient 1 is a 48-year-old man with a pineal region mass. The tumor had unique biphasic patterns, papillary/pseudopapillary areas, and increased mitotic activity. Juxtaposed areas had marked pleomorphism, including nuclear enlargement, smudgy chromatin, nuclear pseudoinclusions, and cytoplasmic vacuolation. Mitoses were absent in these areas. Immunohistochemical staining revealed strong S100 expression. CAM 5.2 and CK18 were strongly positive in a patchy fashion. MIB1 labeling indices were high in classic PTPR regions but very low in pleomorphic areas. Patient 2 was a 35-year-old male with a pineal region tumor characterized by papillary architecture and overall cellular monotony, rare mitoses, and pleomorphism as a more isolated finding, with associated nuclear enlargement and crowding. S100 and CAM 5.2 labeling were present, and MIB1 labeling index was very low throughout the tumor. We discuss the pathologic and phenotypic features of PTPR. Variable pleomorphism may be present, reflected in size variation and nuclear hyperchromasia, but was not accompanied by increased proliferative activity in these cases, suggesting a degenerative phenomenon.

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“…Sasaki et al recently demonstrated histology report of a PPTID case showing marked pleomorphism such as giant cells in the absence of pineocytomatous rosette. 3 To our knowledge, case presentations of pleomorphic PPTID have not been accumulated to date other than their report, however, it should be mentioned that marked pleomorphism including giant cells could be observed in PPTID. 3 Unlikely pineoblastoma, the present tumor cells exhibited very low mitotic activity (1 per 10 high-power fields), and necrosis was not found.…”

Section: Discussionmentioning

confidence: 77%

“…3 To our knowledge, case presentations of pleomorphic PPTID have not been accumulated to date other than their report, however, it should be mentioned that marked pleomorphism including giant cells could be observed in PPTID. 3 Unlikely pineoblastoma, the present tumor cells exhibited very low mitotic activity (1 per 10 high-power fields), and necrosis was not found. Taken together, cytological examination of the present case clearly indicates intermediate features of pineocytoma and pineoblastoma, suggesting the possibility of diagnosis to be PPTID.…”

Section: Discussionmentioning

confidence: 77%

Cytologic feature by squash preparation of pineal parenchyma tumor of intermediate differentiation

Shimada

Nakamura

Kuga

et al. 2008

Diagnostic Cytopathology

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Pineal parenchyma tumor of intermediate differentiation (PPTID) is a very rare intracranial tumor, and pathological investigation limited to immunohistological and ultrastructural analyses have been published to date. Although intraoperative cytology is one of the important approaches for initial diagnosis in brain tumors, no or little studies on cellular morphology of PPTID have been demonstrated due to its rarity. We report here cytological features of PPTID obtained from stereotactic surgical specimens in a case of 27-year-old female manifested by dizziness and diplopia. Brain MRI revealed an unhomogeneously enhanced, large-sized tumor (56 x 52 x 60 mm) mainly located in the pineal region expanding from the midbrain to superior portion of the cerebellum and the fourth ventricle. Squash cytology showed increased nucleocytoplasmic ratio, hyperchromatic nuclei, and small rosette-like cell cluster but cellular pleomorphism was mild to moderate and necrotic background was not observed. Histology showed high cellularity, moderate nuclear atypia, and small rosette formation but neither bizarre tumor cells nor necrosis was present. Mitotic counts were very low (less than 1 per 10 high-power fields) and the MIB-1 labeling index was relatively high (10.1%). Tumor cells were immunohistochemically positive for neural markers such as synaptophysin, neurospecific enolase but not for glial fibrillary acidic protein or S-100. In some parts, cells were strongly reactive for neurofilament protein. Taken together, we made a final diagnosis of PPTID. This is the first presentation of cytological analysis by squash preparation that gives an important clue to accurate diagnosis of pineal parenchymal tumor and to understand its malignant potential.

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Pineal parenchymal tumor of intermediate differentiation with cytologic pleomorphism

Cited by 18 publications

References 17 publications

Pineocytoma and Pineal Parenchymal Tumors of Intermediate Differentiation Presenting Cytologic Pleomorphism: A Multicenter Study

Pineocytoma and Pineal Parenchymal Tumors of Intermediate Differentiation Presenting Cytologic Pleomorphism: A Multicenter Study

Cellular pleomorphism in papillary tumors of the pineal region

Cytologic feature by squash preparation of pineal parenchyma tumor of intermediate differentiation

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