Complex choristoma of the gyrus rectus

A distinct clinicopathologic entity?

Ty W. Abel, Mark Curtis, Doris Lin, Peter C. Burger, Thomas J. Cummings

Research output: Contribution to journalArticle

Abstract

We report 2 cases of an unusual central nervous system lesion involving the gyrus rectus and characterized by well-differentiated epithelial and mesenchymal components. One patient was a 30-year-old woman, and the other was a 42-year-old man. Both presented with seizures. Radiologically, the lesions were solid, with ill-defined margins and increased signal on T2-weighted MRI. Both were contrast enhancing. There was no significant mass effect or edema. Histopathologically, the epithelial component was characterized by a tubule-forming, stratified epithelium. The lumina of the tubules were lined, in some areas, by a distinct layer of mature keratinocytes. Smooth muscle actin-immunoreactive myoepithelial cells were present in the basal layer, indicating glandular differentiation. Some lumina were cystically dilated and contained anucleate squames and/or PAS-positive material. In some areas, the epithelial structures were separated by reactive glial tissue resembling pilocytic astrocytoma, with prominent, piloid processes, Rosenthal fibers, and gemistocytic astrocytes. In other areas, glial nuclei formed small clusters reminiscent of subependymoma, but no glioma was identified in either case. Tissue resembling mature adipose was present focally. No mitotic figures were identified. Follow-up interval of up to 2 years showed no evidence of recurrent tumor. By location and histologic features, this lesion appears to represent a rare, distinct clinicopathologic entity, perhaps derived from misplaced cranial neural crest cells.

Original languageEnglish (US)
Pages (from-to)625-629
Number of pages5
JournalAmerican Journal of Surgical Pathology
Volume30
Issue number5
DOIs
StatePublished - May 2006

Fingerprint

Choristoma
Prefrontal Cortex
Neuroglia
Subependymal Glioma
Neural Crest
Astrocytoma
Keratinocytes
Glioma
Astrocytes
Smooth Muscle
Actins
Edema
Seizures
Epithelium
Central Nervous System
Neoplasms

Keywords

  • Choristoma
  • Gyrus rectus
  • Heterotopia
  • Neural crest
  • Seizure

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Complex choristoma of the gyrus rectus : A distinct clinicopathologic entity? / Abel, Ty W.; Curtis, Mark; Lin, Doris; Burger, Peter C.; Cummings, Thomas J.

In: American Journal of Surgical Pathology, Vol. 30, No. 5, 05.2006, p. 625-629.

Research output: Contribution to journalArticle

Abel, Ty W. ; Curtis, Mark ; Lin, Doris ; Burger, Peter C. ; Cummings, Thomas J. / Complex choristoma of the gyrus rectus : A distinct clinicopathologic entity?. In: American Journal of Surgical Pathology. 2006 ; Vol. 30, No. 5. pp. 625-629.
@article{61a46a0eadb44d5aa1a45718e45e89d7,
title = "Complex choristoma of the gyrus rectus: A distinct clinicopathologic entity?",
abstract = "We report 2 cases of an unusual central nervous system lesion involving the gyrus rectus and characterized by well-differentiated epithelial and mesenchymal components. One patient was a 30-year-old woman, and the other was a 42-year-old man. Both presented with seizures. Radiologically, the lesions were solid, with ill-defined margins and increased signal on T2-weighted MRI. Both were contrast enhancing. There was no significant mass effect or edema. Histopathologically, the epithelial component was characterized by a tubule-forming, stratified epithelium. The lumina of the tubules were lined, in some areas, by a distinct layer of mature keratinocytes. Smooth muscle actin-immunoreactive myoepithelial cells were present in the basal layer, indicating glandular differentiation. Some lumina were cystically dilated and contained anucleate squames and/or PAS-positive material. In some areas, the epithelial structures were separated by reactive glial tissue resembling pilocytic astrocytoma, with prominent, piloid processes, Rosenthal fibers, and gemistocytic astrocytes. In other areas, glial nuclei formed small clusters reminiscent of subependymoma, but no glioma was identified in either case. Tissue resembling mature adipose was present focally. No mitotic figures were identified. Follow-up interval of up to 2 years showed no evidence of recurrent tumor. By location and histologic features, this lesion appears to represent a rare, distinct clinicopathologic entity, perhaps derived from misplaced cranial neural crest cells.",
keywords = "Choristoma, Gyrus rectus, Heterotopia, Neural crest, Seizure",
author = "Abel, {Ty W.} and Mark Curtis and Doris Lin and Burger, {Peter C.} and Cummings, {Thomas J.}",
year = "2006",
month = "5",
doi = "10.1097/01.pas.0000194744.33540.28",
language = "English (US)",
volume = "30",
pages = "625--629",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Complex choristoma of the gyrus rectus

T2 - A distinct clinicopathologic entity?

AU - Abel, Ty W.

AU - Curtis, Mark

AU - Lin, Doris

AU - Burger, Peter C.

AU - Cummings, Thomas J.

PY - 2006/5

Y1 - 2006/5

N2 - We report 2 cases of an unusual central nervous system lesion involving the gyrus rectus and characterized by well-differentiated epithelial and mesenchymal components. One patient was a 30-year-old woman, and the other was a 42-year-old man. Both presented with seizures. Radiologically, the lesions were solid, with ill-defined margins and increased signal on T2-weighted MRI. Both were contrast enhancing. There was no significant mass effect or edema. Histopathologically, the epithelial component was characterized by a tubule-forming, stratified epithelium. The lumina of the tubules were lined, in some areas, by a distinct layer of mature keratinocytes. Smooth muscle actin-immunoreactive myoepithelial cells were present in the basal layer, indicating glandular differentiation. Some lumina were cystically dilated and contained anucleate squames and/or PAS-positive material. In some areas, the epithelial structures were separated by reactive glial tissue resembling pilocytic astrocytoma, with prominent, piloid processes, Rosenthal fibers, and gemistocytic astrocytes. In other areas, glial nuclei formed small clusters reminiscent of subependymoma, but no glioma was identified in either case. Tissue resembling mature adipose was present focally. No mitotic figures were identified. Follow-up interval of up to 2 years showed no evidence of recurrent tumor. By location and histologic features, this lesion appears to represent a rare, distinct clinicopathologic entity, perhaps derived from misplaced cranial neural crest cells.

AB - We report 2 cases of an unusual central nervous system lesion involving the gyrus rectus and characterized by well-differentiated epithelial and mesenchymal components. One patient was a 30-year-old woman, and the other was a 42-year-old man. Both presented with seizures. Radiologically, the lesions were solid, with ill-defined margins and increased signal on T2-weighted MRI. Both were contrast enhancing. There was no significant mass effect or edema. Histopathologically, the epithelial component was characterized by a tubule-forming, stratified epithelium. The lumina of the tubules were lined, in some areas, by a distinct layer of mature keratinocytes. Smooth muscle actin-immunoreactive myoepithelial cells were present in the basal layer, indicating glandular differentiation. Some lumina were cystically dilated and contained anucleate squames and/or PAS-positive material. In some areas, the epithelial structures were separated by reactive glial tissue resembling pilocytic astrocytoma, with prominent, piloid processes, Rosenthal fibers, and gemistocytic astrocytes. In other areas, glial nuclei formed small clusters reminiscent of subependymoma, but no glioma was identified in either case. Tissue resembling mature adipose was present focally. No mitotic figures were identified. Follow-up interval of up to 2 years showed no evidence of recurrent tumor. By location and histologic features, this lesion appears to represent a rare, distinct clinicopathologic entity, perhaps derived from misplaced cranial neural crest cells.

KW - Choristoma

KW - Gyrus rectus

KW - Heterotopia

KW - Neural crest

KW - Seizure

UR - http://www.scopus.com/inward/record.url?scp=33745036216&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745036216&partnerID=8YFLogxK

U2 - 10.1097/01.pas.0000194744.33540.28

DO - 10.1097/01.pas.0000194744.33540.28

M3 - Article

VL - 30

SP - 625

EP - 629

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 5

ER -