Ependymomas: Clinical and Pathological Aspects

Abstract

HE propriety of grading ependymomas by a system based upon histological anaplasia, and the effectiveness of irradiation as an adjunctive measure in treatment, are two of the more controversial topics related to this tumor. Utilizing material from the Armed Forces Institute of Pathology (AFIP) supplemented by cases from the Medical College of Georgia (MCG), we will discuss certain aspects of the classification, pathology, diagnosis, and therapy of ependymomas. Source of Material One hundred and eighty cases were available for study: 167 from the AFIP; 13 from the MCG. The AFIP material consisted of histologicM slides and in many cases gross material from which additional slides could be made along with a clinical summary. The patient population from which this material was taken consisted primarily of military personnel and their dependents, veterans, and occasional civilians where slides had been sent to AFIP for consultation. Talmadge Memorial Hospital at the MCG, on the other hand, is a general referral hospital for the State of Georgia. Cases Excluded. Of the 180 cases, 47 were excluded for one or more of the following reasons: 1. Inadequate pathological material to permit accurate diagnosis. 2. Disagreement with the original diagnosis. Most of these cases were seen before 1940 and originally classified as spongioblastoma ependymale, they are now considered glioblastoma multiforme and so have been omitted. All cases in which the degree of anaplasia was such that the basic ependymal origins were not recognizable were also excluded.