Ependymoma: Difference between revisions
No edit summary |
No edit summary |
||
| Line 5: | Line 5: | ||
== Definition == | == Definition == | ||
Ependymomas are tumors of the central nervous system (CNS), which means that they originate in either the brain or spine. Tumors of glial cells are the most common and are known as gliomas. They effect both adults and children but are most common in children, Tumors are classified by the World Health Organization (WHO) Classification of Tumors of the Nervous System as grades I, II, and III based on their grade of anaplasia (cell disorganisation)<ref name=":0">Cern-foundation.org. (2017). ''Ependymoma Basics | CERN Foundation''. [online] Available at: <nowiki>http://www.cern-foundation.org/education/ependymoma-basics</nowiki> [Accessed 24 Aug. 2017]. | |||
</ref> | |||
== Clinically Relevant Anatomy | == Clinically Relevant Anatomy == | ||
=== Glial cells === | |||
Glial cells are a cell type that are found between nerve cells that share a general function of holding the CNS together. There are more glial cells than nerve cells and thereby constitute half of the total volume of the CNS. The four types of glial cells are: oligodenrocytes, microglia, epndymal cells and astrocytes.<ref>Palastanga, N., Field, D. and Soames, R. (2012). ''Anatomy and Human Movement: Structure and Function''. 6th ed. Burlington: Elsevier Science.</ref> | |||
== | === Ventricals === | ||
Ventricals and the central canal of the spinal cord are fluid-filled spaces within the CNS that contain cerebrospinal fluid. Both are common locations for tumours.<ref name=":0" /> | |||
=== Tentorium Cerebelli === | |||
Tentorium Cerebelli is an extension of the dura matter that separates the cerebellum from the inferior aspect of the occipital lobes. Tumour below the tentorium are called infratentorial and those above are called supratentorial.<ref name=":0" /> | |||
== Pathological Process == | |||
== Clinical Presentation == | == Clinical Presentation == | ||
| Line 21: | Line 27: | ||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Tumors are classified and graded according to their appearance when viewed through the microscope with the most severe tumour associated with a higher grade. | |||
=== World Health Organization (WHO) Classification of Tumors of the Nervous System === | |||
==== Myxopapillary ependymoma (WHO grade I) ==== | |||
This entity is characterised by cuboidal tumour cells, with GFAP expression and lack of cytokeratin expression, surrounding blood vessels in a mucoid matrix. Mitotic activity is very low or absent. 2.1.2. | |||
== | ==== Subependymoma (WHO grade I) ==== | ||
Subependymoma has isomorphic nuclei in an abundant and dense fibrillary matrix with frequent microcysts; mitoses are very rare or absent. 2.1.3. | |||
==== Ependymoma (WHO grade II) ==== | |||
This neoplasm has moderate cellularity; mitoses are rare or absent and nuclear morphology is monomorphic. Key histological features are perivascular pseudorosettes and ependymal rosettes[14]. Four histological variants have been described: cellular ependymoma, which has hypercellularity and increased mitotic rate, papillary ependymoma, clear cell ependymoma and tanycytic ependymoma. | |||
== | ==== Anaplastic ependymoma (WHO grade III) ==== | ||
This tumour is characterised by hypercellularity, cellular and nuclear pleomorphism, frequent mitosis, pseudopalisading necrosis and endothelial proliferation. The latter two criteria do not appear to be independently related to prognosis [15]. Perivascular rosettes are a histological hallmark.<ref>Reni, M., Gatta, G., Mazza, E. and Vecht, C. (2007). Ependymoma. ''Critical Reviews in Oncology/Hematology'', 63(1), pp.81-89. | |||
</ref> | |||
== Management == | |||
add text here relating to management approaches to the condition<br> | add text here relating to management approaches to the condition<br> | ||
Revision as of 18:20, 24 August 2017
Original Editor - George Prudden Lead Editors
Definition[edit | edit source]
Ependymomas are tumors of the central nervous system (CNS), which means that they originate in either the brain or spine. Tumors of glial cells are the most common and are known as gliomas. They effect both adults and children but are most common in children, Tumors are classified by the World Health Organization (WHO) Classification of Tumors of the Nervous System as grades I, II, and III based on their grade of anaplasia (cell disorganisation)[1]
Clinically Relevant Anatomy[edit | edit source]
Glial cells[edit | edit source]
Glial cells are a cell type that are found between nerve cells that share a general function of holding the CNS together. There are more glial cells than nerve cells and thereby constitute half of the total volume of the CNS. The four types of glial cells are: oligodenrocytes, microglia, epndymal cells and astrocytes.[2]
Ventricals[edit | edit source]
Ventricals and the central canal of the spinal cord are fluid-filled spaces within the CNS that contain cerebrospinal fluid. Both are common locations for tumours.[1]
Tentorium Cerebelli[edit | edit source]
Tentorium Cerebelli is an extension of the dura matter that separates the cerebellum from the inferior aspect of the occipital lobes. Tumour below the tentorium are called infratentorial and those above are called supratentorial.[1]
Pathological Process[edit | edit source]
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition
Diagnostic Procedures[edit | edit source]
Tumors are classified and graded according to their appearance when viewed through the microscope with the most severe tumour associated with a higher grade.
World Health Organization (WHO) Classification of Tumors of the Nervous System[edit | edit source]
Myxopapillary ependymoma (WHO grade I)[edit | edit source]
This entity is characterised by cuboidal tumour cells, with GFAP expression and lack of cytokeratin expression, surrounding blood vessels in a mucoid matrix. Mitotic activity is very low or absent. 2.1.2.
Subependymoma (WHO grade I)[edit | edit source]
Subependymoma has isomorphic nuclei in an abundant and dense fibrillary matrix with frequent microcysts; mitoses are very rare or absent. 2.1.3.
Ependymoma (WHO grade II)[edit | edit source]
This neoplasm has moderate cellularity; mitoses are rare or absent and nuclear morphology is monomorphic. Key histological features are perivascular pseudorosettes and ependymal rosettes[14]. Four histological variants have been described: cellular ependymoma, which has hypercellularity and increased mitotic rate, papillary ependymoma, clear cell ependymoma and tanycytic ependymoma.
Anaplastic ependymoma (WHO grade III)[edit | edit source]
This tumour is characterised by hypercellularity, cellular and nuclear pleomorphism, frequent mitosis, pseudopalisading necrosis and endothelial proliferation. The latter two criteria do not appear to be independently related to prognosis [15]. Perivascular rosettes are a histological hallmark.[3]
Management[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis
[edit | edit source]
add text here relating to the differential diagnosis of this condition
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ 1.0 1.1 1.2 Cern-foundation.org. (2017). Ependymoma Basics | CERN Foundation. [online] Available at: http://www.cern-foundation.org/education/ependymoma-basics [Accessed 24 Aug. 2017].
- ↑ Palastanga, N., Field, D. and Soames, R. (2012). Anatomy and Human Movement: Structure and Function. 6th ed. Burlington: Elsevier Science.
- ↑ Reni, M., Gatta, G., Mazza, E. and Vecht, C. (2007). Ependymoma. Critical Reviews in Oncology/Hematology, 63(1), pp.81-89.
