CNS & pituitary tumors

Gliomas, glioneuronal tumors, and neuronal tumors

Neuronal and mixed neuronal-glial tumors

Gangliocytoma & ganglioglioma

Last author update: 1 July 2013
Last staff update: 14 November 2022 (update in progress)

Copyright: 2002-2022,, Inc.

PubMed Search: Ganglion cell [title] tumors

Eman Abdelzaher, M.D., Ph.D.
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Cite this page: Abdelzaher E. Gangliocytoma & ganglioglioma. website. Accessed December 9th, 2022.
Definition / general
  • Well differentiated neuroepithelial tumors composed of neoplastic ganglion cells (gangliocytoma) or combination of neoplastic ganglion cells and neoplastic glial component (ganglioglioma)
  • < 2% of all brain tumors
  • Ages 2 months to 70 years, with predilection for children and young adults
  • Throughout CNS but > 70% involve the temporal lobe
Clinical features
  • Associated with long term epilepsy
  • Gangliocytoma, WHO grade I
  • Ganglioglioma, WHO grade I
  • Anaplastic ganglioglioma, WHO grade III
  • Criteria for grade II are not yet established
Radiology description
  • Circumscribed solid mass or cyst with a mural nodule
  • Variable enhancement, variable calcification
Radiology images

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Anaplastic ganglioglioma:
Case reports


Anaplastic ganglioglioma:
Gross description
  • Solid or cystic
  • No hemorrhage or necrosis
Gross images

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Hypothalamo - infundibular region

Microscopic (histologic) description
  • Compact growth pattern
  • The hallmark of ganglion cell tumors is the presence of dysplastic / neoplastic ganglion cells that are identified by:
    • Loss of cytoarchitectural organization
    • Abnormal (subcortical) localization
    • Clustering
    • Large neurons (cytomegaly)
    • Coarse peripherally aggregated Nissl substance
    • Bi or multinucleated neurons with prominent nucleoli

  • Neoplastic ganglion cells
  • Stroma: finely fibrillar neuropil rich

  • Neoplastic ganglion cells
  • Neoplastic glial component:
    • Constitutes the proliferative component of the tumor (Ki67 is 1.1 to 2.7%)
    • Astrocytic: resemble fibrillary astrocytoma or pilocytic astrocytoma
    • Variable lobular architecture
    • Rare mitoses, no necrosis
  • Common features:
    • Perivascular lymphocytic cuffing
    • Rosenthal fibers and eosinophilic granular bodies
    • Microcysts
    • Rich reticulin network
    • Calcification
    • Glomeruloid vascular proliferation
    • Desmoplasia, especially with tumors involving the subarachnoid space

Anaplastic ganglioglioma:
  • Anaplastic changes involving the glial component
    • Increased mitotic activity
    • Vascular proliferation
    • Necrosis
  • Anaplastic changes in neuronal component are rare
Cytology images

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Ganglion cell with prominent nucleoli and neoplastic astrocytes

Positive stains
Electron microscopy description
  • Neurons with dense core granules are characteristic and diagnostically useful
Differential diagnosis
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