title: Pleomorphic granular cell astrocytoma in the pineal gland: case report.
abstract: Pleomorphic granular cell astrocytoma in the pineal region is exceedingly rare, and its clinicopathological features are distinctive. A 67-year-old woman was admitted with a staggering gait. Magnetic resonance imaging revealed a mass lesion at the pineal gland accompanied by obstructive hydrocephalus. Following surgery, pathological examinations demonstrated a pleomorphic granular cell astrocytoma. The patient has been free from recurrence for 24 months after surgery without adjuvant therapy. The specimen exhibited nuclear and cytoplasmic pleomorphism. The nuclei varied in size, shape and coarseness. Variability was also observed in the eosinophilic granular bodies, Rosenthal fibers and spindle-shaped tumor cells. GFAP, S-100 and vimentin were immunohistochemically positive. Reticulin network was absent between the tumor cells, and granular cells with ballooned cytoplasm showing positive staining for PAS. Pleomorphic granular cell astrocytoma is believed to be a form of astrocytoma originating from the pineal gland. Its clinicopathological features resemble those of pleomorphic xanthoastrocytoma. However, it can be differentiated from the latter by the absence of reticulin fibers, absence of basement membrane between adjacent cells, and presence of large numbers of mitochondria.
authors.affiliation: Department of Neurological Surgery, Division of Neurosurgery and Pathology, Nihon University School of Medicine, Tokyo, Japan. otakashi@med.nihon-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yachi
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogino
authors.forename: Takakazu
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Takao
authors.initials: T
authors.lastname: Fukushima
authors.forename: Takao
authors.initials: T
authors.lastname: Watanabe
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yoshino
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
authors.forename: Taku
authors.initials: T
authors.lastname: Honma
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
mesh_terms: D000368:Aged; D001254:Astrocytoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019635:Neurosurgical Procedures; D010871:Pinealoma / Q000473:pathology* / Q000601:surgery