Extraventricular neurocytomas: Pathologic features and clinical outcome

D. J. Brat, B. W. Scheithauer, Charles G Eberhart, P. C. Burger

Research output: Contribution to journalArticle

Abstract

Neurocytic neoplasms usually arise within the lateral ventricles, generally as circumscribed, slowly growing masses curable by total resection. Both subtotal resection and histologic atypia are associated with an increased risk of recurrence. In contrast, neurocytic neoplasms situated within brain parenchyma, so-called "extraventricular neurocytomas" (EVNs), are not as well characterized. The relationships between histologic features and extent of resection versus clinical behavior have not been defined. We evaluated pathologic features, clinical data, and neuroimaging of 35 examples. The tumors occurred in 18 males and 17 females, age 5-76 years (median 34 years). All tumors involved the cerebrum. On imaging, EVNs were solitary, variably contrast-enhancing, and often (57%) cystic. Tumor cells were arranged in sheets, clusters, ribbons, or rosettes, in association with fine neuropil dispersed in broad zones that separated cell aggregates. Ganglion cell differentiation was seen in 66%. All tumors showed strong synaptophysin immunoreactivity. Despite the lack of apparent astrocytes in hematoxylin and eosin-stained sections, focal glial fibrillary acidic protein reactivity was seen in 46%. Eleven EVNs were designated "atypical" based on the presence of necrosis, vascular proliferation, or elevated mitotic activity (≥3 mitoses/10 high power fields). Nineteen tumors were subtotally resected or biopsied, whereas 14 were totally resected grossly. Seventeen patients underwent radiotherapy (mean 55 Gy). In 30 cases with follow-up, 10 tumors recurred, 3 causing death at 6, 14, and 43 months. All 10 recurrences followed subtotal resection. No totally resected tumors recurred. Thus, the majority of EVNs are well differentiated and appear unlikely to recur after gross total resection. Subtotal resection, atypical histologic features, and high cell proliferation rates correlate with recurrence.

Original languageEnglish (US)
Pages (from-to)1252-1260
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume25
Issue number10
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Neurocytoma
Neoplasms
Recurrence
Synaptophysin
Neuropil
Lateral Ventricles
Glial Fibrillary Acidic Protein
Cerebrum
Hematoxylin
Eosine Yellowish-(YS)
Mitosis
Neuroimaging
Ganglia
Astrocytes
Blood Vessels
Cell Differentiation
Necrosis
Radiotherapy
Cell Proliferation

Keywords

  • Brain tumor
  • Neurocytoma
  • Synaptophysin

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Extraventricular neurocytomas : Pathologic features and clinical outcome. / Brat, D. J.; Scheithauer, B. W.; Eberhart, Charles G; Burger, P. C.

In: American Journal of Surgical Pathology, Vol. 25, No. 10, 2001, p. 1252-1260.

Research output: Contribution to journalArticle

Brat, D. J. ; Scheithauer, B. W. ; Eberhart, Charles G ; Burger, P. C. / Extraventricular neurocytomas : Pathologic features and clinical outcome. In: American Journal of Surgical Pathology. 2001 ; Vol. 25, No. 10. pp. 1252-1260.
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