PMC3700453_01
Axial contrast enhanced MRI Brain demonstrated the heterogeneously enhancing mass in the pineal gland with extension to the tectum causing obstructive hydrocephalus.
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The mass measured 2.0x2.0 cm in size, and was hyperintense on T2 and hypointense on T1 (Figure 1A-D).
Immunohistochemical slides of malignant papillary glioneuronal tumor of the pineal gland. (A) Hematoxylin and Eosin staining at 20x magnification showing glial processes. (B) Hematoxylin and Eosin Stain 20x showing glial architecture. (C) Hematoxylin and Eosin staining at 40x showing abnormal nuclei pattern. (D and E) Synaptophysin positive indicating neuronal nature of the tumor. (F) Ki67 proliferative index strongly positive at 20%. (G and H) GFAP and Ki67 staining at 20x showing the strong proliferative index of the abnormal glial cells. (I) GFAP and Ki67 immunostaining at 100x demonstrating the strong proliferative index of the abnormal glial cell. (J and K) MAP and Ki67 combined immunostaining demonstrating the high proliferative indices within the abnormal neuronal cells.
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Pathology demonstrated a rare high grade glioneuronal tumor (Figure 2A-K).