%0 Journal Article
%T Cytokeratin positivity in myxopapillary ependymoma ¨C a potential diagnostic pitfall
%A Sundus A Hussein
%A Monalisa Sur
%J Diagnostic Pathology
%D 2008
%I BioMed Central
%R 10.1186/1746-1596-3-40
%X We describe two cases of MPE with cytokeratin (AE1 AE3, CAM 5.2, Cytokeratin 7 and cytokeratin 20) expression.MPE can be positive for Cytokeratins (CAM 5.2, AE1 AE3, CK7) and focally for EMA, which could be misdiagnosed as metastatic carcinoma. In cases demonstrating epithelioid and clear cell morphology, the diagnosis of MPE should be made in conjunction with histology, proper immunohistochemical profile which includes co-expression of GFAP, S-100 protein and epithelial markers, radiologic findings and site. It is important to be aware of the cytokeratin profile in MPE to avoid erroneous diagnosis with other tumour entities.Myxopapillary ependymomas (MPE) generally occur in the filum terminale of the spinal cord, however, they have been described in extra-spinal locations such as subcutaneous tissue [1] and brain [2]. They are slow growing gliomas corresponding to WHO grade I [3]. The classical morphology shows papillae embedded in a myxoid/mucoid background. Each papilla contains a central fibrovascular core and is lined by cuboidal to elongated cells, occasionally showing clear cytoplasm. Microcysts are also present. The myxoid background contains both neutral and acidic mucopolysaccharides. Prognosis depends on the completeness of excision [4]. However, areas of solid growth pattern with aggregates of cells with "epithelioid morphology" can also be encountered which can mimic metastatic carcinoma. In addition, the presence of cells with clear cytoplasm can also be mistaken for chordoma. Diagnosis is easily missed due to these morphological similarities, which could affect patient management and hence, long term survival. A good number of studies have reported the immunophenotype of MPE and differential diagnosis of MPE aided by immunohistochemical stains [5-7]. Several studies have reported absence of cytokeratin expression in MPE [8-10].We describe two cases of MPE with cytokeratin expression. Two female patients, aged 46 and 72 years respectively presented wit
%U http://www.diagnosticpathology.org/content/3/1/40