Heme Bodies (Rosenthal Fibres) associated with Cavities in Pons and Cerebellum and Acoustic Neurinoma: With a Report of Two Cases.

Abstract

FROM the time of their discovery in 1898 1 up to 1936, Rosenthal fibres have been reported in only five certain cases.1 2 3 4 5 They are elongated, microscopic bodies, found near syringomyelic cavities. They stain deeply with iron and chrome haematoxylin lakes. In all cases they have occurred in connexion with syringomyelia or syringobulbia and intramedullary tumour of the spinal cord or medulla. They are always very abundant. The nature of these structures has remained obscure. In a previous paper the author 6 reported a typical case of Rosenthal fibres with syringomyelia, syringobulbia and an intramedullary ependymoma. This was the sixth case that could be found in the available literature. It was shown that Rosenthal fibres had most of the optic, tinctorial and histochemical characteristics of haemoglobin and were consequently made up of a substance closely akin to, if not identical with it-that is, a heme substance. The name 'heme bodies' was therefore suggested in place of Rosenthal fibres. Considering the large number of reports published about syringomyelia, heme bodies would seem to be exceedingly rare. Yet, in the article referred to above, the author expressed some doubts as to their actual rarity. If they were present in small numbers, the observer whose attention was not specially drawn to them could easily pass them by. Their staining affinities are wide, so that they might be confused with other objects which stain in the same way. This has happened in one known case, where structures first described as fragments of myelin by Leupold 7 were later shown to be Rosenthal fibres by Kirch.4 Since the first case of heme bodies observed in this laboratory, they have been sought systematically in all sections of nervous tissue examined. This is not difficult to do as heme bodies, when once seen, are very easy to see and identify. They have so far been observed in three new cases. One was the