Abstract
Background: Myxopapillary ependymoma (MPE) is a distinctive variant of ependymoma that is almost exclusively observed in the filum terminale. We report a case of MPE arising in spinal cord, which was effectively diagnosed by intraoperative cytological examination.
Case: The patient was a 19-year-old female with a chief complaint of lower back pain, that had begun 6 years ago, MRI examination and myelography revealed an intradural extramedullary tumor at the spinal level, Th 11-L 3. Intraoperative cytological examination showed several larg e clusters, fernlike papillae structure, and globules of myxoid substance that was enhanced by alcian blue and PAS stain, The globules were rimmed by tumor cells. Pseudorosette formation was also observed. Tumor cells showed mildly pleomorphic, elongated cytoplasms, round or oval nuclei, and fine chromatin. Immunocytochemical study detected strong glial fibrillary acidic protein positivity in fibrillated tumor cells. Ultrastructurally, a few intercellular spaces contained microvilli. Occasionally cilia were seen in tumor cells.
Conclusion: In intraoperative rapid diagnosis of MPE it is helpful to prepare imprint and crush cytology smears in addition to tissue sections.
