Indian Journal of Pathology and Microbiology
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Year : 2019  |  Volume : 62  |  Issue : 2  |  Page : 296-299

Composite pleomorphic xanthoastrocytoma-ganglioglioma; assessing and addressing the dilemma of differential expression of neuronal markers: Case report with diagnostic perspective

1 Assistant Professor, Department of Pathology, Lady Hardinge Medical College, New Delhi, India
2 Assistant Professor, Department of Pathology, All India Institute of Medical Sciences, Patna, India
3 Department of Pathology, GB Pant Institute of Postgraduate Medical Education and Research, 1, Jawaharlal Nehru Marg, New Delhi, India
4 Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar East, Gautam Nagar, New Delhi, India

Correspondence Address:
Ravindra K Saran
Department of Pathology, Academic Block, G B Pant Institute of Postgraduate Medical Research and Education, 1, Jawaharlal Nehru Marg, New Delhi - 110 002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJPM.IJPM_458_18

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We report the case of a 5-year-old male child presenting with seizures for 4 months. Magnetic resonance imaging (MRI) revealed a cortical-based solid cystic lesion in the right parietal lobe. Histopathological examination showed a tumour comprised of spindled glial fibrillary acid protein (GFAP) positive neoplastic cells interspersed with bizarre pleomorphic cells showing nuclear pseudoinclusions and intermingled dysplastic ganglion cells variably immunopositive for synaptophysin, chromogranin, Neu-N and immunonegative for neuron filament protein (NFP). This report highlights the occurrence of the rare composite pleomorphic xanthoastrocytoma-ganglioglioma and the vagaries of immunohistochemical analysis in highlighting neuronal differentiation in such a case setting. In addition, to the best of our knowledge this is the youngest patient till date to present with this entity.

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