Unclassified glioneuronal tumor with advanced lipidization |
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Authors: | Ewa Matyja Wies?awa Grajkowska Przemyslaw Kunert Andrzej Rysz Andrzej Marchel |
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Institution: | (1) Department of Experimental and Clinical Neuropathology, M. Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland;(2) Department of Pathology, Children’s Memorial Health Institute, Warsaw, Poland;(3) Department of Neurosurgery, M. Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland;(4) Department of Neurosurgery, Warsaw Medical University, Warsaw, Poland;(5) Department of Neuropathology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawinskiego Str., 02-106 Warsaw, Poland |
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Abstract: | Lipidization is observed only occasionally in primary neuroectodermal tumors of the central nervous system. It may reflect
lipomatous transformation of tumor cells into xanthomatous and/or adipocyte-like cells. We report a unique case of mixed glioneuronal
tumor with marked lipomatous changes in a young patient with intractable epilepsy. MRI revealed a well-circumscribed lesion
in the right temporal lobe. Histopathological findings showed the pleomorphic tumor with numerous cells containing large lipid
droplets, resembling mature adipocytes, that were arranged in clusters or scattered within the neoplastic tissue. The tumor
was composed of both glial and neuronal elements. Some tumor cells displayed features intermediate between glial and neuronal
cells. The reticulin fibers were limited to blood vessels. Mitotic figures, vascular proliferation, and necrosis were absent,
and MIB-1 labeling index was less than 1%. Diffuse immunoreactivity for GFAP and S100-protein was observed. In some heavily
lipidized cells, the lipid droplets were surrounded by a cytoplasmic rim of GFAP immunoreactivity. Numerous cells exhibited
immunostaining for NSE and synaptophysin. This is the first documented case of glioneuronal tumor with extensive lipomatous
transformation, which might be considered as a heavily lipidized unclassified pleomorphic glioneuronal tumor or a variant
of lipoganglioglioma with marked pleomorphism and severe lipidization. |
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