Ghosal Nandita, Thakar Sumit, Kumaran Sunitha P, Hegde A S
Department of Pathology and Transfusion Medicine, SSSIHMS, Bangalore, India.
Diagn Cytopathol. 2012 Feb;40(2):155-8. doi: 10.1002/dc.21606. Epub 2011 Feb 13.
We report a rare case of recurrent chordoid glioma in suprasellar region with extension into the third ventricle diagnosed peroperatively. On MRI, a brilliantly contrast enhancing lesion in the suprasellar region extending superiorly into the third ventricle and measuring 2.5 × 3 × 3.5 cm was identified. Patient had a previous history of subtotal removal of the tumor 8 months back and had received 56 Gy of postoperative radiotherapy. On smear preparation the tumor was composed of cells arranged in chords and rows in a myxoid background with sprinkling of lymphocytes. The individual cells were polygonal with moderate amount of faintly eosinophilic cytoplasm with cytoplasmic vacoules in few cells. The nuclei showed fine chromatin with small prominent nucleoli. Paraffin sections confirmed the diagnosis and on immunohistochemistry the tumor cells showed strong positivity for GFAP and focal weak positivity for EMA with low MIB-1 labeling index (<1%). To the best of our knowledge this is the first documented case of chordoid glioma described on crush cytology.
我们报告了一例罕见的鞍上区复发性脊索样胶质瘤，术中诊断其已延伸至第三脑室。在磁共振成像（MRI）上，发现鞍上区有一个强化明显的病变，向上延伸至第三脑室，大小为2.5×3×3.5厘米。患者8个月前曾接受过肿瘤次全切除术，并接受了56 Gy的术后放疗。涂片检查显示，肿瘤由排列成索状和行状的细胞组成，位于黏液样背景中，散在淋巴细胞。单个细胞呈多边形，有中等量淡嗜酸性细胞质，少数细胞有细胞质空泡。细胞核显示细染色质，有小而明显的核仁。石蜡切片证实了诊断，免疫组织化学显示肿瘤细胞对胶质纤维酸性蛋白（GFAP）呈强阳性，对上皮膜抗原（EMA）呈局灶弱阳性，增殖细胞核抗原（MIB-1）标记指数低（<1%）。据我们所知，这是第一例在压碎细胞学上描述的脊索样胶质瘤病例。
