Subependymal Reaction Secondary to Choroid Plexus Papilloma in a Horse

Choroid plexus papilloma (CPP) is a rare, benign, intracranial neoplasm. The present report described a choroid plexus papilloma of the fourth ventricle with unusual proliferative reaction of ependymal/subependymal cells in a stallion. A single, soft neoformation, red-gray in color, with an irregular surface, resembling a cauliflower, expanding from the fourth ventricle to the cerebellar peduncles was observed. Microscopically, the neoformation was composed of a single layer of simple cuboidal to columnar epithelium with a well-vascularized papillary-arboriform pattern. Multifocal subependymal aggregates forming rosettes were observed near the mesencephalic aqueduct (MA). Glial-fibrillary-acidic-protein (GFAP) was markedly positive only in the neuropil adjacent to the proliferative areas of the MA. Ependymal/subependymal reactions secondary to CPP have never been described in equine or human neuropathology. The capabilities of ependymal cells to regenerate and eventually proliferate are controversial and unclear and, thus, require additional investigation to understand the adaptive mechanisms of this rare pathogenic condition.