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

Pineocytoma with astrocytic differentiation

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Increasing headaches

Patient Data

Age: Adult

A large enhancing mass is present in the pineal region compressing the tectum and resulting in obstructive hydrocephalus. 

The patient went on to have surgery and resection of the mass. 

Histology

Sections show a tumor comprised of cells with small rounded nuclei with a moderate degree of pleomorphism. Some hyperchromatic nuclei are present, some of these with eosinophilic cytoplasmic inclusions. Cells show minimal cytoplasm but show elongated cell processes. In many areas the tumor shows anuclear zones. Mitoses are rare (there is only one seen in all of the sections). There is no endothelial proliferation and there is no necrosis. Immunohistochemistry shows that the tumor is strongly positive for synaptophysin and focally positive for neuron-specific enolase. Many of the tumor cells are positive for glial fibrillary acidic protein (GFAP).

Case Discussion

Path proven pineocytoma.

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.