FIGURE LEGEND
Fig.1. (A) MRI shows enhancing diffusion restricted fairly large well defined T2/Flair heterogeneously hyperintense mass in left parietal lobe with effacement of adjacent sulci and gyri and mild midline shift. (B) Histology demonstrated neuropils surrounded by small blue round cell tumors in diffuse sheets and rosettes surrounded by single layer of small round blue cells. (C)Synaptophysin staining of sheets of small round blue cells. Other IHC stains demonstrated (not shown) GFAP patchy +, NeuN patchy +, Olig2 -, Chromogranin –, LIN28 –, INI-1 retained, Desmin -, EMA -. Ki67 was ~20%. (D) Unsupervised clustering (tSNE plot; Supplement: Methods) showed that the tumor grouped closest with ETMR (red arrow). (E) Copy number aberrations plot derived from methylation profiling. (F) Focused analysis (using the conumee package; Supplement: Methods) revealed no structural variation at C19MC region. (G) The MGMT promoter was methylated.
[Abbreviations in figure : FLAIR: Fluid-attenuated inversion recovery. DWI: Diffusion weighted imaging. MB: Medulloblastoma. EPN: Ependymoma. PF: Posterior fossa. HGG: High-grade glioma. GBM: Glioblastoma. MES: Mesenchymal. MID: Midline. K27M: Diffuse midline glioma, K27-altered. G34R: Diffuse hemispheric glioma, G34-mutant. PXA: Pleomorphic xanthoastrocytoma. Ana-PA: Anaplastic pilocytic astrocytoma. ATRT: Atypical teratoid rhabdoid tumor. ETMR: Embryonal tumor with multilayered rosettes. HGNET: High-grade neuroepithelial tumor. NB: Neuroblastoma. EWS: Ewing sarcoma. EFT: Ewing family tumor. MGMT: O(6)-Methylguanine-DNA-methyltransferase.]