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Year : 2010  |  Volume : 58  |  Issue : 5  |  Page : 805-806

Liponeurocytoma of lateral ventricle

1 Deparment of Lab Medicine Fortis Hospital Mohali, Mohali, Punjab, India
2 Deparment of Lab Medicine, Northern Institute of Neurosciences Chandigarh, Mohali, Punjab, India

Date of Acceptance21-Jul-2010
Date of Web Publication28-Oct-2010

Correspondence Address:
Ritu Pankaj
Deparment of Lab Medicine Fortis Hospital Mohali, Mohali, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.72195

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How to cite this article:
Pankaj R, Jindal A, Banerjee AK. Liponeurocytoma of lateral ventricle. Neurol India 2010;58:805-6

How to cite this URL:
Pankaj R, Jindal A, Banerjee AK. Liponeurocytoma of lateral ventricle. Neurol India [serial online] 2010 [cited 2022 Aug 7];58:805-6. Available from: https://www.neurologyindia.com/text.asp?2010/58/5/805/72195


Cerebellar liponeurocytoma (LN) is a rare neoplasm showing neuronal, glial, and focal lipomatous differentiation [1] It is among the most frequent central nervous system (CNS) neuroepithelial tumors which show lipidization; however existence of such lipocytic differentiation within a central neurocytoma is very rare. [2] In this communication we report one more case of LN of lateral ventricle.

We recently encountered a 35-year-old male who had presented to the neurosurgical department with complaints of intermittent severe headache associated with blurring of vision and diplopia of six months duration. His chief complaint was generalized weakness. Neurological examination revealed bilateral papilledema and bilateral sixth nerve palsy. Routine hematology and blood biochemistry were within normal limits. The magnetic resonance imaging (MRI) brain scan revealed an inhomogeneously enhancing large intraventricular mass filling the body and lateral horn of right ventricle. The mass measured 5×3×1 cm and showed areas of calcification. Patient underwent right frontal craniotomy, and complete tumor excision by mid frontal gyrus approach. Patient required a ventriculoperitoneal shunt on the tenth post-operative day. His subsequent recovery was satisfactory and at the time of discharge his Glasgow coma scale score was 14.

On gross examination, the mass appeared well marginated, partly calcified and pinkish grey in color. Light microscopy revealed sheets of monomorphic cells with rounded nuclei and clear cytoplasm, resembling oligodendrocytes. There was a fine fibrillary background and several foci showed mature adipose tissue intimately mixed with other tumor cells. Fine capillaries were also seen between the groups of cells [Figure 1]. Extensive secondary changes consisting of hemorrhage, hyalinization, and cystic degeneration were interspersed with areas showing hemosiderin pigment and calcification. Immuno-histochemically the tumor cells were positive for synaptophysin but the fat cells were negative. GFAP immunostaining showed a variable degree of positive staining. In some fields it was clearly related to trapped astrocytes, whereas in other fields this was more intimately related to the tumor. A diagnosis of central LN was made.

The process of lipidization in this neoplasm is a subject of debate. While some authors describe it as true adipose metaplasia of neuroectodermal cells, [3] others suggest it to be simple lipidization of tumor cells. [4] Evidence of neuronal nature of neoplasm comes from the immunohistochemical profile which is positive for neuronal markers such as neuron-specific enolase, synaptophysin and chromogranin. [5]

Topography plays an important role in neuropathology in differential diagnosis of morphologically similar lesions; however using a specific site limited term such as cerebellar liponeurocytoma restricts the use of tumor nomenclature at other sites. Our case showed glial, neuronal and lipomatous differentiation in a lesion which was located in lateral ventricle; therefore a less committal term such as central liponeurocytoma seemed more appropriate as it encompasses all neurocytic tumors with lipomatous differentiation irrespective of the location. The biological behavior of such tumors is quite unpredictable as shown by a recent publication where recurrence and malignant progression has been reported. [6] Long-term follow up studies of large number of cases will help to understand the biological behavior of this rare tumor. It further needs to be seen whether there is difference of biological behavior of tumor in cerebellar and extracerebellar location.
Figure 1 :The tumor showing sheets of monomorphic cells with round nuclei and clear cytoplasm. Mature adipose tissue is seen intimately mixed with other tumor cells, H and E, x100

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Only five cases of liponeurocytoma (LN) of lateral ventricle have been reported until 2007 including one case in which one of us is a co-author.

 » Acknowledgment Top

We thank Director Fortis hospital Mohali and Dr Simi Bhatia, National Head, Histopathology, Super Religare Ltd, Mumbai for their assistance in immunohistochemistry of this case.

 » References Top

1.Kachhara R, Bhattacharya RN, Nair S, Radhakrishnan VV. Liponeurocytoma of the cerebellum - A case report . Neurol India 2003;51:274-6.  Back to cited text no. 1
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2.Rajesh LS, Vasishta RK, Chhabra R, Banerjee AK. Case report Central liponeurocytoma. Neuropathol Appl Neurobiol 2003;29:511-3.  Back to cited text no. 2
3.Roda JM, Gutierrez-Molina M. Multiple intraspinal low grade astrocytoma mixed with lipoma(astrolipoma). Case report. J Neurosurg 1995;82:891-4.  Back to cited text no. 3
4.Kleihues P, Cavenee WK. Cerebellar liponeurocytoma. Pathology and Genetics of Tumours of Central Nervous System. Chapter 6. Lyons, France: IAPC Press; 2000. p. 110-1.   Back to cited text no. 4
5.Huchitanda Y, Tsuneyoshi M, Enjoji M. Expression of panneuroendocrine proteins in 53 neuroblastic tumors. An immunohistochemical study. Arch Pathol Lab Med 1989;113:381-8.  Back to cited text no. 5
6.Pasquale G, Maria BA, Vania P, Gastone P, Nicola DL. Cerebellar liponeurocytoma: An updated follow-up of a case presenting histopathological and clinically aggressive features. Neurol India 2009;57:194-6.  Back to cited text no. 6
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  [Figure 1]

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