title: A case of multinodular high-grade neuroepithelial tumor with ependymal differentiation.
abstract: We describe a rare case of multinodular cerebral neuroepithelial tumor with ependymal differentiation. A 65-year-old man experienced loss of consciousness with an obscure episode of seizure attack. Magnetic resonance images disclosed a lesion located in the left temporal lobe and the insular cortex. The tumor was partially removed. Histologically, the tumor showed infiltrating multinodular tumor nodules in the cerebrum. Each nodule was well demarcated and composed of clear cells with perinuclear halos, intermingled fibrillary cells, and poorly differentiated neuroepithelial cells with mitotic activity. Immunohistochemically, clear cells showed dot-like positivity for epithelial membrane antigen. Fibrillary cells were positive for vimentin and nestin, whereas only a few glial fibrillary acidic protein-immunopositive cells were seen. We conclude that this tumor, being microscopically characterized by multinodular tumor nodules, was a high-grade neuroepithelial tumor with ependymal differentiation.
authors.affiliation: Department of Neurosurgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8102, Japan. k-kamada@nagasaki-u.ac.jp
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kamada
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsuo
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
authors.forename: Kenta
authors.initials: K
authors.lastname: Ujifuku
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Suyama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakazato
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagata
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004806:Ependymoma / Q000175:diagnosis / Q000473:pathology; D005904:Glial Fibrillary Acidic Protein; D006801:Humans; D007150:Immunohistochemistry; D007381:Intermediate Filament Proteins; D008279:Magnetic Resonance Imaging; D008297:Male; D018396:Mucin-1 / Q000032:analysis; D009419:Nerve Tissue Proteins; D064231:Nestin; D018242:Neuroectodermal Tumors, Primitive / Q000175:diagnosis / Q000473:pathology; D046569:Neuroepithelial Cells / Q000473:pathology; D012640:Seizures / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology*; D014746:Vimentin
chemical_list: D005904:Glial Fibrillary Acidic Protein; D007381:Intermediate Filament Proteins; D018396:Mucin-1; C577484:NES protein, human; D009419:Nerve Tissue Proteins; D064231:Nestin; D014746:Vimentin