Presentation
Numbness right arm and leg for 2 months.
Patient Data
Expansile intramedullary tumor extending over the length of the cervical spine with a tumoral cyst expanding the medulla - favored to represent an ependymoma with the main differential of hemangioblastoma. No evidence of drop metastases and normal intracranial examination.
Case Discussion
Intramedullary mass: Hemangioblastoma, WHO grade 1.
Microscopic Description: Specimen 1 and 2: Intramedullary mass. Specimens 1 and 2 each have similar features and are described together. Both specimens show a tumor consistent with a hemangioblastoma. The tumor is composed of sheets of cells with moderately abundant bubbly clear cytoplasm and moderately pleomorphic, hyperchromatic nuclei. Throughout the tumor is a rich network of capillary vessels. Mitotic figures are not seen. Nucleoli are inconspicuous. Immunohistochemistry The tumor cells with the clear bubbly cytoplasm are positive for inhibin and negative for EMA, D2-40 and CD10. CD10 highlights moderate numbers of mast cells in the tumor. CD31 is negative in the bubbly cells but positive in the extensive vascular network within the tumor.
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