Virtual Microscope
A 40 year-old man with a tumor in the posterior fossa
Elizabeth Rushing, M.D., Col.
Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, D.C.
Last updated: February 28, 2006
Clinical Information: The patient is a 40 year-old man who complained of headache and ataxia. MRI demonstrated a tumor in the posterior associated with a cyst. The following image is obtained from the permanent section of the tumor.
Diagnosis: Capillary hemangioblastoma (WHO grade I).
Pathology: The tumor has a rich capillary network. The tumor cells are clear cell in appearance without significant mitosis. Mitosis are not readily seen. There is no necrosis or other feature indicative of a sinister nature. Together with the MRI findings, the most appropriate diagnosis is capillary hemangioiblastoma (WHO grade I). On immunohistochemistry, this tumor is positive for inhibin which confirms the diagnosis.
Comment: The diagnosis of hemangioblastoma on permanent sections is usually straight forward. These tumors, however, has close morphological similarities with metastatic renal cell carcinoma. Immunohistochemistry for cytokeratin and CD10 would be positive in metastatic renal cell carcinoma but negative in hemangioblastoma.