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Ahn JS, Petersen M, Friedman AH, López EM, Cummings TJ, Buckley AF, López GY. Eosinophilic globules in a classic ependymoma: evidence of a possible secretory role. Ultrastruct Pathol 2020; 44:511-518. [PMID: 33148106 DOI: 10.1080/01913123.2020.1843578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A number of neoplasms of the central nervous system can demonstrate diffuse eosinophilic globules, known to be secretory products of the corresponding cell type, but they have not been a salient feature in descriptions of classic ependymoma. Here, we present a case of a posterior fossa ependymoma demonstrating glassy PAS-positive, diastase-resistant, eosinophilic globules with light microscopic and ultrastructural features resembling Reissner fiber, the secretory product of the subcommissural organ. While there has been a single published description of an ependymoma with intra- and extracellular granulofibrillary material suggested to be evidence of secretory differentiation, ours is the first case to demonstrate diffuse eosinophilic globules in an ependymoma. The extent of globules allowed full study by electron microscopy to provide new insight into the secretory material and the surrounding structures. Our findings suggest that neoplastic ependymal cells can recapitulate the secretory capacity of the subcommissural organ.
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Affiliation(s)
- Janice S Ahn
- Department of Pathology, Duke University School of Medicine , Durham, North Carolina, USA
| | - Maureen Petersen
- Department of Pathology, Duke University School of Medicine , Durham, North Carolina, USA
| | - Allan H Friedman
- Department of Neurosurgery, Duke University School of Medicine , Durham, North Carolina, USA.,Duke Cancer Institute, Duke University School of Medicine , Durham, North Carolina, USA
| | - Edward M López
- Triad Radiology Associates, Winston-Salem, North Carolina, USA
| | - Thomas J Cummings
- Department of Pathology, Duke University School of Medicine , Durham, North Carolina, USA.,Duke Cancer Institute, Duke University School of Medicine , Durham, North Carolina, USA
| | - Anne F Buckley
- Department of Pathology, Duke University School of Medicine , Durham, North Carolina, USA
| | - Giselle Y López
- Department of Pathology, Duke University School of Medicine , Durham, North Carolina, USA.,Department of Neurosurgery, Duke University School of Medicine , Durham, North Carolina, USA.,Duke Cancer Institute, Duke University School of Medicine , Durham, North Carolina, USA
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Kawano N, Yasui Y, Utsuki S, Oka H, Fujii K, Yamashina S. Light microscopic demonstration of the microlumen of ependymoma: A study of the usefulness of antigen retrieval for epithelial membrane antigen (EMA) immunostaining. Brain Tumor Pathol 2004; 21:17-21. [PMID: 15696964 DOI: 10.1007/bf02482172] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To determine the origin of dotlike epithelial membrane antigen (EMA) immunoreactivity of ependymoma, which is consistent with the eosinophilic globular body in hematoxylin and eosin (H&E) stain, an immunoelectron microscopic study was undertaken. The usefulness of antigen retrieval pretreatment in detecting the dotlike EMA immunoreactivity in ependymomas was also studied. The materials were 29 ependymomas, 7 autopsy brains as a normal control, and 50 brain tumors of various types. The study confirmed that most of the brown dots in EMA immunostain in ependymoma represented microlumina of tumor cells. In ependymomas, plain EMA immunostaining showed dotlike positivity in only six cases (21%), and antigen retrieval pretreatment increased the number of positives up to 26 cases (90%). Antigen retrieved CD99 detected 23 positive cases (80%) in ependymomas. On the basis of the results, although some false positive findings were raised by antigen retrieval pretreatment, the authors positively recommend adoption of the technique, especially when ependymoma remains as one of the differential diagnoses of the tumor.
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