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Presented by Jonathan Epstein, M.D. and prepared by Jospeh Kronz, M.D.
Case 3: Lower back pain in a 13-year-old female
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Question 1 of 1
1. Question
Week 2: Case 3
Lower back pain in a 13-year-old female
Correct
Answer: Myxopapillary ependymoma
Histology: Within a background of cells with ovoid nuclei and slight cytoplasmic processes are rounded myxoid pools. In some planes of sections, one can appreciate within the center of these myxoid pools a fibrovascular core. In the best developed regions of this lesion, nuclei palisade around and send elongated processes towards the fibrovascular core.
Discussion: A more fibrillary neuropil matrix characterizes the other entities listed as diagnostic choices. The only lesion listed in the differential diagnosis that has a myxoid appearance is pilocytic astrocytoma. In pilocytic astrocytomas, the myxoid pools are not circumscribed rounded structures with central fibrovascular cores, but rather represent myxoid degeneration within a glial background of astrocytic cells with long fibrillary processes.
Incorrect
Answer: Myxopapillary ependymoma
Histology: Within a background of cells with ovoid nuclei and slight cytoplasmic processes are rounded myxoid pools. In some planes of sections, one can appreciate within the center of these myxoid pools a fibrovascular core. In the best developed regions of this lesion, nuclei palisade around and send elongated processes towards the fibrovascular core.
Discussion: A more fibrillary neuropil matrix characterizes the other entities listed as diagnostic choices. The only lesion listed in the differential diagnosis that has a myxoid appearance is pilocytic astrocytoma. In pilocytic astrocytomas, the myxoid pools are not circumscribed rounded structures with central fibrovascular cores, but rather represent myxoid degeneration within a glial background of astrocytic cells with long fibrillary processes.
