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Figure 1
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caption:Radiology and pathology features of embryonal tumor with multilayered rosettes

label: (TOP ROW) MRI shows typical features of ETMR in a18-month-old girl: well delimited, large supratentorial intra-axial mass within the right thalami, measuring 4 x 3,8 x 3,8 cm and crossing midline, causing mild supratentorial hydrocephalus due to Silvian aqueduct compression. The lesion is hypointense in T1 (A) and hyperintense in T2 and FLAIR with multiple and small necrotic and cystic foci (B, C). There is no contrast enhancement (A). ADC map (D) demonstrated diffusion restriction, revealing high cellularity, consistent with a malignant embryonal tumor. (BOTTOM ROW) Pathology revealed an undifferentiated neoplasm with a diffuse pattern of proliferation in H-E stains consisting on pleomorphic cells with large areas of atypia and necrosis, abundant nucleoli, and cell-wrapping (E). There were some ependymoblastic rosettes (F). Immunoreactivity for Ki67 was 99% (G) INI-1 was retained in tumor cells (H) and LIN28 immunostain was avidly positive (I). Further molecular analysis revealed C19MC amplification by FISH (not shown). (Contributed by Dr. Adriana Fonseca.)