New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20-year radiological–pathological study of 37 cases

Mai Lan Ho, Kathryn L. Eschbacher, Michael A. Paolini, Aditya Raghunathan

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Aims: Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare entity that can occur anywhere within the central nervous system. Histologically, CAPNON has been characterised as a benign, calcified, fibro-osseous lesion with a characteristic chondromyxoid fibrillary matrix with dense calcification and varying degrees of spindle, epithelioid, fibrous, meningothelial and giant cells. The underlying aetiology of CAPNON is controversial and incompletely understood. The aim of this study was to perform a comprehensive radiological and histological review to further characterise this entity. Methods and results: In this article, we review our institutional 20-year experience including 37 cases of CAPNON with detailed pathological analysis, evaluation of concurrent lesions, correlation with radiological imaging, and critical review of the literature. The classic histological finding of chondromyxoid matrix was present in one-third of cases. Underlying or dual pathologies were frequent, and included diverse underlying conditions. Radiologically, dense calcification and dural attachment were the most common features. Enhancement was often low, but was more prominent in the setting of inflammatory changes, aggressive growth, and dual pathology. Conclusion: Our results suggest that CAPNON represents a spectrum of reactive processes that can arise in association with diverse underlying pathologies, including inflammatory, degenerative, vascular and neoplastic lesions.

Original languageEnglish (US)
Pages (from-to)1056-1070
Number of pages15
JournalHistopathology
Volume76
Issue number7
DOIs
StatePublished - Jun 1 2020

Keywords

  • CAPNON
  • CRUDoma
  • calcifying pseudoneoplasm

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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