Noshuyo byori = Brain tumor pathology最新文献

We have reported 7 cases of giant cell glioblastoma. All cases died within 14 months despite aggressive treatment. By immunohistochemical staining, lymphocyte infiltration was found in 6 cases. GFAP and vimentin stained positive in all cases. The MIB-1 positive rate was 13.8-90% (average, 34.9%); small and mononucleated giant cells stained more than multinucleated and monstrous cells. It was concluded that this tumor can be highly malignant and its degree of malignancy is determined by the biological behavior of the mononucleated giant cells and small cells.

This report concerns the clinical and histopathologic findings in five patients with meningioma and two with hemangioblastoma who underwent embolization with polyvinyl alcohol (PVA) particles before surgery. Angiography revealed loss of tumor stain from the main feeders in all seven patients, with markedly decreased contrast enhancement of computed tomography (CT) and magnetic resonance imaging (MRI) in six of them. Tumor excision was readily accomplished in all instances, with minimal bleeding from the tumor. In the patient operated 1 day after embolization there were almost no necrotic lesions, even though hemorrhage, presumably due to the surgical procedure was noted. Necrotic lesions and island-like residual tumor cells around the vessels were seen in the patient operated two days after embolization. Extended necrotic lesions were noted among patients who underwent surgery at day 4 and thereafter. Revasculization was not found, even in the patient operated one week after embolization. Massive bleeding (due presumably to the surgical procedure, suggesting recanalization) was noted in the tissue of a hemangioblastoma patient who underwent surgery 13 days after embolization, even though tumor excision was easy. In the patient subjected to the surgical procedure 694 days following embolization, the CT and MRI performed 2 months later, revealed contrast enhancement similar to that seen before the operation. Moreover, angiography, done after 5 months, demonstrated tumor stain as had been noted before embolization. The histopathologic examination of this case reveal the presence of extended necrotic lesions, a large number of macrophages that contained PVA particles, and destruction of the walls of the onceoccluded vessels. In addition, there were many blood-filled vessels that had achieved recanalization. These findings suggest that it is desirable to operate within 7 days after embolization, since recanalization occurs during this period, even though PVA particles remain unabsorbed for a long time.

We report the case of a 16-year-old boy who presented with mesenchymal chondrosarcoma involving the ethmoid sinus, right orbit, nasal cavity, and anterior cranial fossa. The tumor was totally resected by craniofacial surgery; the patient's postoperative course was uneventful. Microscopically, the tumor was composed of highly cellular undifferentiated small cells, alternating with zones of cartilaginous tissues. Mesenchymal chondrosarcoma is a rare, aggressive variant of chondrosarcoma, which might be encountered more frequently due to the advances in neuroimaging and surgical procedures.

The correlation between S- and G2/M-phase fractions and MIB-1 index in meningiomas was investigated. Flow cytometric analyses were performed on cell suspensions from 81 samples of paraffin-embedded tissue from 29 patients with a total of 28 meningiomas and 1 hemangiopericytoma using the modified Hedley's method. Sections from the paraffin-embedded tissues were stained with anti-MIB-1 monoclonal antibody after microwave oven processing. Five hundreds cells were scored. Correlations between data were estimated using linear regression. DNA aneuploidy was present in 4/29 tumors. Mean S- and G2/M-phase fractions in the 25 nonrecurrent tumors were 1.77 and 4.76%, and in the recurrent tumors were 2.41 and 5.81%, respectively. The proliferative index (PI = S + G2/M fraction) was 6.52% in the nonrecurrent tumors and 8.29% in the recurrent tumors. The mean MIB-1 score in the nonrecurrent tumors was 1.25% and in the recurrent tumors was 2.69%. There was a linear correlation between percentage of S-phase fraction or PI and the MIB-1 score. Both methods are useful to assess the proliferative activity in meningioma.

To elucidate the morphological characteristics of glioma in children, we investigated 83 tumors that occurred in patients under the age of 20 years old. Seven of 20 histologically malignant tumors were adult-type anaplastic astrocytoma and glioblastoma. Eleven tumors were composed of small undifferentiated or poorly differentiated cells. The tumors usually had no fibrillary stroma or if present, the stroma was scanty. A few tumors exhibited ependymal differentiation. One tumor showed rhabdoid features. In 63 benign tumors, including 28 pilocytic astrocytomas and 15 ependymomas, there were 6 plemorphic tumors. Four were regarded as pleomorphic xanthoastrocytoma (PXA), and contained a few neurofilament-positive cells. Further-more, an unclassified glioma composed of eosinophilic plump cells coexpressed glial fibrillary acidic protein and neurofilament protein in identical cells. There were 6 tumors associated with desmoplasia including PXA and desmoplastic infantile astrocytoma (DIA). Characteristics of gliomas in children were considered to be the presence of tumors showing insufficient expression of glial phenotype, expression of neurofilament in some types of gliomas, and the presence of a special type of glioma with conspicuous desmoplasia, including PXA and DIA.

Seven human glioma cell lines were examined for mutations of the p53 gene and their mRNA and protein expressions. Five cell lines revealed a missense mutation at, codons 237, 245, or 273. Their p53 mRNA expression was variably distinct and not always comparable to p53 protein expression, suggesting difference in the transcriptional and posttranscriptional regulation. One cell line had a splicing mutation in intron 9 and abnormal splicing was actually demonstrated by RT-PCR analysis. The remaining 1 cell line showed no PCR-amplification of the p53 gene sequence. In an examination of the original tumor tissues, the same mutations were demonstrated in the 5 tumors examined, strongly suggesting that the mutations in the glioma cell lines were derived from their original tumor tissues.

This report concerns a case of fibrous astrocytoma with palisade features that mimics a polar spongioblastoma. The patient was a 54-year-old female who presented with a tumor of the frontal lobe. The presence of neurites, with or without synaptic devices were considered to represent the entrapment by the tumors of the pre-existing neurons and their processes.

Gliomatosis cerebri is a rare disease that thus far was usually diagnosed at the time of autopsy. In this communication we report the case of a young woman with gliomatosis cerebri. Diagnosis was established on the basis of characteristic imaging findings and typical histopathological features of surgical specimens obtained by craniotomy.

Due to the low incidence of intramedullary spinal cord tumors there have been few reports considering its proliferative kinetics. In this study, expression of two cell cycle related antigens (PCNA and MIB-1) were immunohistochemically examined by the percentage of positively stained cells were recorded as PCNA and MIB-1 indices. In addition, over-expression of p53 protein was also investigated in 19 cases of intrameduallary spinal cord tumors. In astrocytic tumors and ependymomas, statistically significant correlations were observed between PCNA and MIB-1 indices (R = 0.98). In hemangioblastoma cases, a similar correlation was not observed between PCNA and MIB-1 indices. The MIB-1 indices of hemangioblastoma cases were less than 1.56 while PCNA indices were more than 14.63 despite long-term survival occurred in all cases. The PCNA index in hemangioblastoma was significantly greater (p < 0.01) than all other types of tumors except for glioblastomas. Thus, interpretation of PCNA index must be made with caution in regard to the subgroup of the tumor histology. Over-expression of the p53 protein was observed only in glioblastoma cases. The MIB-1 index appears to be a useful method for predicting the outcome of all cases with intramedullary tumors of the spinal cord.