The Common Vein Copyright 2010
A central neurocytoma is characterized as an intraventricular mass composed of uniform neoplastic cells with features of neuronal differentiation. It is a tumor that generally affects young adults.
The exact cell lineage from where they arise is uncertain. The histologic findings support a neuronal cell lineage however some evidence supports that they arise from progenitor cells also capable of glial differentiation. They are currently considered a neuroepithelial tumor
Pathologically, these cells appear as uniform round cells with round or oval nuclei, similar to oligodendrogliomas They also demonstrate expression of multiple neuronal markers on immunohistochemical studies. On electron microscopy neuronal cell elements such as microtubules and neurosecretory granules can be seen.
This intraventricular mass is most commonly located in the lateral ventricle, adjacent to the foramen of Monro and is attached to the septum pellucidum and leads to obstructive hydrocephalus.
Patients present with signs of increased intracranial pressure such as headache, nausea and vomiting.
Diagnosis is suggested by classic imaging findings but is ultimately made by pathologic evaluation.
Central neurocytomas are imaged by both CT and MRI. On CT, these are generally well circumscribed, lobulated masses which may be hyperdense and about half of the time, contain internal calcification. On MRI these lesions are heterogeneous on T1, isointense to hyperintense to gray matter on T2 with areas of both low T1 and T2 hypointensity which may be due to calcification or flow within vessels. After contrast administration, there is mild to moderate heterogeneous enhancement.
The first line of treatment is surgery and when complete it is curative. Radiation, chemotherapy or radiosurgery can be used after incomplete resection.
MRI and CT scan
Image Courtesy Elisa Flower MD and Asim Mian MD97634c01.8s
Neuronal Nuclii Positive
Images Courtesy of Cheryl Spencer, M.A. and Ivana Delalle, MD, PhD Department of Pathology Boston University School of Medicine 98487 (S07-412)