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<p class="ql-align-justify">Cellular tumor composed of proliferating monomorphic elongated cells arranged around markedly thickened and extensively hyalinized blood vessels with their nuclei being placed away from the basement membrane of these vessels (ependymal pseudorosettes). In areas, these cells are confluent forming sheet-like masses. In other smaller foci, these cells form pseudorosettes around fibrillary processes. Foci of tumor necrosis are noted. Areas of calcification are observed. Despite marked increase in cellularity, mitotic activity is not increased and cellular features do not show anaplastic features enough to qualify for anaplastic astrocytoma. This is consistent with ependymoma, WHO grade 2.</p>
<p>Posterior fossa mass (cystic with solid nodule).</p>
<p class="ql-align-justify">Soft tissue fragments collectively measured 4.5x3.5x1 cm, largest measured 2.5x2x1 cm.</p>
<p><strong><em><u>Posterior Fossa mass, Biopsy:</u></em></strong></p><ul><li><strong>Ependymoma, CNS</strong> <strong>WHO Grade 2. </strong></li><li class="ql-align-justify"><strong>Molecular Subgroup (Provisional):</strong> Likely <strong>Posterior Fossa Group A (PFA)</strong> given the patient's age and tumor location.</li></ul><p class="ql-align-justify"><br></p><h5><strong><u>COMMENT</u></strong><u>:</u></h5><h5 class="ql-align-justify">Given the patient’s age and the tumor’s location in the posterior fossa, these findings are highly suggestive of a <strong>PFA (Posterior Fossa Group A)</strong> molecular subgroup. Correlation with H3K27me3 immunohistochemistry and/or DNA methylation profiling is recommended, as PFA status is associated with a more guarded prognosis and a higher risk of recurrence regardless of the histological grade.</h5>
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