IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Central neurocytoma

Case contributed by RMH Neuropathology
Diagnosis certain

Presentation

Patient referred for evaluation of a intraventricular tumor.

Patient Data

Age: 18
Gender: Female

MRI Brain

mri

A large mass of heterogeneous signal and enhancement is seen within the frontal horn of the left lateral ventricle. The septum pellucidum is bowed to the left. The mass abuts the head of the caudate nucleus. There is obstructive hydrocephalus evident with transependymal spread on the right. Overall dimensions of the mass are 37.5 millimeters SI, 35 mm transverse and 36 mm AP. There is raised mild pulsatile and minimally increased choline within the mass. There is elevated cerebral blood volume (CBV) within the lesion.

Conclusion:

Findings compatible with a central neurocytoma.

pathology

MACROSCOPIC DESCRIPTION:

1. "Brain tissue": Fragments of soft gelatinous tissue up to 3mm. Portion for frozen section/smear. Remaining tissue for formalin plus glutaraldehyde (hold for EM).

2. "Brain tissue": Multiple pieces of soft tan tissue 17x15x3mm in aggregate. A1. 

MICROSCOPIC DESCRIPTION:

1&2. Paraffin sections show a moderately hypercellular tumor. Tumor cells have uniform medium sized round nuclei with granular chromatin and delicate processes and are arranged on lobules and solid sheets in a neuropil-like background. Scattered cells are undergoing apoptosis. No mitotic figures are identified. Small capillaries are prominent throughout the tumor but no multilayering of atypical cells around vessel lumena is seen. There is no necrosis.

Immunohistochemistry shows that tumor cells are positive for synaptophysin and NeuN. GFAP and tyrosinase are negative.

The features are of central neurocytoma (WHO Grade II).

DIAGNOSIS:

"Intraventricular tumor": Central neurocytoma (WHO Grade II).

Case Discussion

Central neurocytomas are WHO Grade II neuroepithelial intraventricular tumors with fairly characteristic imaging features, appearing as heterogeneous masses of variable size and enhancement within the lateral ventricle. They are typically seen in young patients, and generally have a good prognosis provided a complete resection can be achieved. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.