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*[[IDH-1]]-ve. |
*EMA (dots and rings).<ref>{{Cite journal | last1 = Hasselblatt | first1 = M. | last2 = Paulus | first2 = W. | title = Sensitivity and specificity of epithelial membrane antigen staining patterns in ependymomas. | journal = Acta Neuropathol | volume = 106 | issue = 4 | pages = 385-8 | month = Oct | year = 2003 | doi =... |
**Widespread and strong EMA expression is indicative of YAP1-fused ependymoma. |
*Olig2-ve.<ref>{{Cite journal | last1 = Švajdler | first1 = M. | last2 = Rychlý | first2 = B. | last3 = Mezencev | first3 = R. | last4 = Fröhlichová | first4 = L. | last5 = Bednárová | first5 = A. | last6 = Pataky | first6 = F. | last7 = Daum | first7 = O. | title = SOX10 and Olig2 as negative markers for the diagnosi... |
*H3K27me3 nuclear loss in Posterior fossa group A ependymoma (nuclear loss is diagnostic).<ref>{{Cite journal | last1 = Panwalkar | first1 = P. | last2 = Clark | first2 = J. | last3 = Ramaswamy | first3 = V. | last4 = Hawes | first4 = D. | last5 = Yang | first5 = F. | last6 = Dunham | first6 = C. | last7 = Yip | first... |
*L1CAM in supratentorial tumors (expression indicates ZFTA fusion).<ref>{{Cite journal | last1 = Parker | first1 = M. | last2 = Mohankumar | first2 = KM. | last3 = Punchihewa | first3 = C. | last4 = Weinlich | first4 = R. | last5 = Dalton | first5 = JD. | last6 = Li | first6 = Y. | last7 = Lee | first7 = R. | last8 = ... |
*p65 nuclear +ve in ZFTA-fused ependymoma. |
==Molecular== |
'''Supratentorial Ependymoma''' |
*SE, ZFTA-fusion positive: Adults and children (up to 80% of cases).<ref>{{Cite journal | last1 = Parker | first1 = M. | last2 = Mohankumar | first2 = KM. | last3 = Punchihewa | first3 = C. | last4 = Weinlich | first4 = R. | last5 = Dalton | first5 = JD. | last6 = Li | first6 = Y. | last7 = Lee | first7 = R. | last8 =... |
**ZFTA-RELA fusion most common alteration. |
**Chromothripsis. |
**EPHB2 amplifications and CDKN2A deletions in a subset of these tumors<ref>{{Cite journal | last1 = Philip-Hollingsworth | first1 = S. | last2 = Hollingsworth | first2 = RI. | last3 = Dazzo | first3 = FB. | title = Host-range related structural features of the acidic extracellular polysaccharides of Rhizobium trifol... |
*SE, YAP-fusion positive. |
**Restricted to children (6-7% of all supratentorial ependymomas). |
**YAP-MAMLD fusion most common alteration. |
'''Posterior fossa Ependymoma''' |
Two distinct molecular subgroups exist in the posterior fossa:<ref>{{Cite journal | last1 = Witt | first1 = H. | last2 = Mack | first2 = SC. | last3 = Ryzhova | first3 = M. | last4 = Bender | first4 = S. | last5 = Sill | first5 = M. | last6 = Isserlin | first6 = R. | last7 = Benner | first7 = A. | last8 = Hielscher | ... |
* Group A ependymomas: |
**typically found in children. |
**laterally. |
**relatively unfavorable clinical outcome. |
**CpG island methylator phenotype.<ref>{{Cite journal | last1 = Mack | first1 = SC. | last2 = Witt | first2 = H. | last3 = Piro | first3 = RM. | last4 = Gu | first4 = L. | last5 = Zuyderduyn | first5 = S. | last6 = Stütz | first6 = AM. | last7 = Wang | first7 = X. | last8 = Gallo | first8 = M. | last9 = Garzia | first... |
**Loss of H3K27me.<ref>{{Cite journal | last1 = Panwalkar | first1 = P. | last2 = Clark | first2 = J. | last3 = Ramaswamy | first3 = V. | last4 = Hawes | first4 = D. | last5 = Yang | first5 = F. | last6 = Dunham | first6 = C. | last7 = Yip | first7 = S. | last8 = Hukin | first8 = J. | last9 = Sun | first9 = Y. | title... |
* Group B ependymomas: |
**typically adults. |
**midline. |
**relatively favorable clinical outcomes. |
**gene expression profiles similar to that of spinal cord ependymomas. |
**increased Chromosomal 1q gains. <ref>{{Cite journal | last1 = Korshunov | first1 = A. | last2 = Witt | first2 = H. | last3 = Hielscher | first3 = T. | last4 = Benner | first4 = A. | last5 = Remke | first5 = M. | last6 = Ryzhova | first6 = M. | last7 = Milde | first7 = T. | last8 = Bender | first8 = S. | last9 = Witt... |
==See also== |
*[[Subependymoma]]. |
*[[Myxopapillary ependymoma]]. |
*[[Neuropathology tumours]]. |
==References== |
{{Reflist|1}} |
[[Category:Diagnosis]] |
[[Category:Neuropathology tumours]] |
c9c1386f9e143d5f9deb4b0b6aed0d835e27779b537333fec1fff20b0425b204 librepath-ependymoma.txt |
{{ Infobox diagnosis |
| Name = {{PAGENAME}} |
| Image = Breast fibradenoma (1).jpg |
| Width = |
| Caption = Fibroadenoma. [[H&E stain]]. |
| Synonyms = |
| Micro = abundant (intralobular) stroma usu. white/pale +/-hyalinization, typically paucicellular, compression of glandular elements with perserved myoepithelial cells |
| Subtypes = juvenile, complex, myxoid, cellular, tubular adenoma of the breast |
| LMDDx = [[phyllodes tumour]], [[sarcoma]], [[pseudoangiomatous stromal hyperplasia]], [[adenomyoepithelioma]] for [[tubular adenoma of the breast]] |
| Stains = |
| IHC = |
| EM = |
| Molecular = |
| IF = |
| Gross = well-circumscribed, rubbery, tan/white, +/-lobulated appearance, +/-short slit-like spaces, +/-calcifications |
| Grossing = |
| Site = [[breast]] |
| Assdx = |
| Syndromes = |
| Clinicalhx = |
| Signs = |
| Symptoms = |
| Prevalence = very common |
| Bloodwork = |
| Rads = typically BIRADS4 - see ''[[BIRADS]]'' |
| Endoscopy = |
| Prognosis = benign |
| Other = |
| ClinDDx = other breast tumours - esp. [[phyllodes tumour]] |
| Tx = conservative excision |
}} |
'''Fibroadenoma''', abbreviated '''FA''', is a common benign tumour of the [[breast]]. |
It is a type of [[fibroepithelial tumours of the breast|fibroepithelial tumour]]. |
==General== |
*Very common benign finding. |
*The pathology is in the stroma; so, the lesion is really a misnomer by the naming rules. |
**It ought to be called ''adenofibroma'' (as a few occasionally do<ref name=pmid15797289>{{Cite journal | last1 = Guinebretière | first1 = JM. | last2 = Menet | first2 = E. | last3 = Tardivon | first3 = A. | last4 = Cherel | first4 = P. | last5 = Vanel | first5 = D. | title = Normal and pathological breast, the histol... |
Management: |
*Local excision -- without a large margin. |
==Gross== |
Features:<ref>{{Ref PCPBoD8|550}}</ref> |
*Well-circumscribed. |
*Rubbery - '''classic descriptor'''. |
*Tan/white. |
*+/-Lobulated appearance. |
*+/-Slit-like spaces - short. |
*+/-Calcification. |
===Images=== |
*[http://webpathology.com/image.asp?n=2&Case=276 Fibroadenoma - slit-like spaces (webpathology.com)]. |
*[http://webpathology.com/image.asp?case=276&n=3 Fibroadenoma - lobulated appearance (webpathology.com)]. |
*[http://www.surgical-tutor.org.uk/default-home.htm?tutorials/fibroadenoma.htm~right Fibroadenoma (surgical-tutor.org)]. |
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