• 대한세포병리학회지
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• 제10권1호
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• pp.73-78
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• 1999

Myxopapillary ependymoma generally arise in the conus medullaris and filum terminale of adult spinal cord. These tumors are readily recognized due to unique histopathologic features, however, their cytologic features are not well described. When only a tiny sample is obtained, cytologic examination using crush preparation may be a useful diagnostic tool to help appropriate intraoperative diagnosis. We present the crush cytologic features of myxopapillary ependymoma arising in thoracic and lumbar spinal cord of a 13-year-old boy. The patient had complained of paraparesis and back pain for 1 month. The MRI image revealed a relatively well demarcated intramedullary mass in T11-L1 levels. Crush preparation for cytology were peformed by biopsy material. Crush cytologic findings revealed high cellularity and small sized branching papillary clusters on fibrillary or mucinous background. The tumor cells had uniform round or elongated nuclei. The cytoplasmic process of tumor cells were attached to the vascular wall. Between the tumor cells and vascular walls, the perivascular collar of globoid acellular stroma with metachromatic reaction on toluidin blue stain was noted. The crush preparation of myxopapillary ependymoma is considered as a simple and highly accurate diagnostic tool for differentiation from other intramedullary neoplasms of central nervous system.

• Journal of Korean Neurosurgical Society
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• 제39권5호
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• pp.378-381
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• 2006

A 65-year-old woman presented with a history of severe lower back pain on forward-flexion for 2 months duration. Magnetic resonance Imaging revealed a high signal mass with a tail on T1-weighted images at the L3 level. A total surgical resection was performed via a posterior approach with the aid of a microscope. Histopathological examination of the tumor revealed two pathological components : lipoma and myxopapillary ependymoma. The presence of dual histological components in one spinal cord tumor is rare. There are no prior reports of both types of cells [adipose and ependymal] grown simultaneously in a single tumor of the filum terminale in the medical literature. We report a unique case of the co-existence of lipoma and myxopapillary ependymoma within the same tumor located at the filum terminale and review related literature.

• Journal of Korean Neurosurgical Society
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• 제39권5호
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• pp.382-384
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• 2006

We report a rare case of primary intradural extramedullary myxopapillary ependymoma of the spinal cord. A 45-year-old woman was admitted to the author's institution with a history of progressive paraparesis[grade IV/IV] with back pain. Neurologic examination revealed decreased sensation below T12 sensory dermatome level. Magnetic resonance imaging[MRI] revealed an intermediate enhanced intradural extramedullary tumor extending from T12. Total resection of the tumor was achieved by T12 laminectomy. Intraoperatively, there was no finding of attachment to rootlet and dura. Histopathological examination identified the tumor as a myxopaillary ependymoma. To the best of my knowledge, this is the first reported case of primary intradural extramedullary ependymoma in Korea.

• 대한영상의학회지
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• 제84권5호
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• pp.1066-1079
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• 2023

목적 경막내척수외 뇌실막세포종의 임상 및 영상 특성에 대한 보고는 드물다. 하지만, 발생 위치와 병리학적 특성을 고려하였을 때 점액유두상 뇌실막세포종과 구별하기 어렵다. 본 연구는 경막내척수외 뇌실막세포종과 척수 점액유두상 뇌실막세포종을 구별하기 위한 임상적 특징 및 MRI 영상 특징을 조사하였다. 대상과 방법 종양 크기, 종양의 종축/횡축 위치, 조영 정도/패턴, 동공, 종양 변연, T2 강조 영상(T2-weighted image), T1 강조 영상(T1-weighted image; 이하 T1WI), 종양 아래의 cerebrospinal fluid (이하 CSF) T1 신호강도 증가 및 CSF space로의 종양 전파에 대하여 12개의 병리학적으로 확인된 경막내척수외 뇌실막세포종과 10개의 병리학적으로 확인된 척수 점액유두 뇌실막세포종을 대상으로 분석을 하였다. 또한, 분류 및 트리 분석(classification and tree analysis; 이하 CART) 을 수행하여 경막내척수외 척수 뇌실막세포종을 점액유두 뇌실막세포종과 구별하는 데 중요한 임상적 특징 및 MRI 영상 특징을 조사하였다. 결과 경막내척수외 뇌실막세포종 환자는 척수 점액유두 뇌실막세포종 환자보다 유의하게 나이가 많았으며(48세 vs. 29.5세, p < 0.05), T1W1에서 높은 신호 강도는 점액유두상 뇌실막세포종보다 경막내척수외 척수 뇌실막세포종에서 더 자주 관찰되었다(p = 0.02). 반대로 점액유두상 뇌실막세포종은 지주막하강으로의 종양의 파급을 보였다. CSF 신호 강도는 경막내 척수외 척수 뇌실막세포종보다 점액유두 뇌실막세포종에서 더 자주 관찰되었다(p < 0.05). 종양 아래로의 CSF T1 신호 증가 및 CSF space로의 종양 전파는 경막내척수외 척수 뇌실막세포종과 점액유두 뇌실막세포종을 구별하기 위한 CART 분석에서 가장 중요한 변수였다. 결론 경막내척수외 뇌실막세포종과 척추 점액유두 뇌실막세포종을 구별하는 데 있어 임상 및 MRI 영상의 특징이 도움이 될 수 있다.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.454-456
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• 2023

• Journal of Korean Neurosurgical Society
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• 제59권2호
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• pp.83-90
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• 2016

Ependymomas occur in both the brain and spine. The prognosis of these tumors sometimes differs for different locations. The genetic landscape of ependymoma is very heterogeneous despite the similarity of histopathologic findings. In this review, we describe the genetic differences between spinal ependymomas and their intracranial counterparts to better understand their prognosis. From the literature review, many studies have reported that spinal cord ependymoma might be associated with NF2 mutation, NEFL overexpression, Merlin loss, and 9q gain. In myxopapillary ependymoma, NEFL and HOXB13 overexpression were reported to be associated. Prior studies have identified HIC-1 methylation, 4.1B deletion, and 4.1R loss as common features in intracranial ependymoma. Supratentorial ependymoma is usually characterized by NOTCH-1 mutation and p75 expression. TNC mutation, no hypermethylation of RASSF1A, and GFAP/NeuN expression may be diagnostic clues of posterior fossa ependymoma. Although MEN1, TP53, and PTEN mutations are rarely reported in ependymoma, they may be related to a poor prognosis, such as recurrence or metastasis. Spinal ependymoma has been found to be quite different from intracranial ependymoma in genetic studies, and the favorable prognosis in spinal ependymoma may be the result of the genetic differences. A more detailed understanding of these various genetic aberrations may enable the identification of more specific prognostic markers as well as the development of customized targeted therapies.