Noshuyo byori = Brain tumor pathology最新文献

In the present study, an analysis was made of chromosomal aberrations in brain tumors using the fluorescence in situ hybridization (FISH) technique. At the same time DNA histograms were obtained by flow cytometry (FCM) to make a comparative study of histological malignancy and prognosis. The subjects included 30 gliomas (7 of astrocytoma grade II, 15 of anaplastic astrocytoma (grade III), 8 of glioblastoma (grade IV)) and 26 meningiomas. In the study of FISH, DNA probes for chromosomes No. 7, 9, 10, and 17, were used to cause a reaction with chromosome No. 22 added for meningiomas. In the study with FCM, DNA index from DNA histogram was calculated using lymphocytes as the internal standard. In gliomas as a whole, chromosomes No. 7 and 17 showed high values, whereas, chromosomes No. 9 and 10 low values. Analysis by the grades of glioma showed that compared with gliomas of other grades, grade IV gliomas were higher for chromosome No. 17 and lower for chromosome No. 10. In meningiomas, while many cases showed a low value for chromosome No. 22, most cases of recurrent and atypical meningiomas showed a high value for chromosome No. 17. In gliomas, DNA index showed a correlation with the grade, and a positive correlation particularly with chromosome No. 17 in FISH. Recurrent and atypical meningiomas had a high DNA index.

The apoptotic cells in situ of normal tissues and human brain tumors were analyzed by the modified method of TUNEL, and the relationship between the localization of apoptotic cells and the expression of bcl-2 protein was examined. The localization of apoptotic cells in normal tissue was situated at fast renewing tissues, and differed from the localization of the expression of bcl-2 protein. In the cases of medulloblastoma, 7 out of 8 cases (87.5%) showed apoptotic cells. In contrast to the results of high frequency of apoptotic cells in medulloblastoma and germinoma, the expression of bcl-2 protein was found very low incidence in those tumors, which were thought to be sensitive against radiation or chemotherapy. These results suggested that the detection of apoptosis in situ by this method could predict the sensitivity of radiation or chemotherapy of the tumor cells.

Four patients with hypothalamic hamartoma were examined by CT and/or MR imaging, immunohistochemistry and electron microscopy. The hamartomas arose from the hypothalamus and extended inferiorly. LH-RH neurons were detected in three cases by immunohistochemistry. Electron microscopy revealed large myelinated axons, axon terminals containing dense-core vesicles and axon terminals with clear vesicles forming asymmetrical synapses. The development of hypothalamic hamartoma and its functional manifestations (precocious puberty and laugh attacks) are discussed in reference to the migration of LH-RH neurons from the olfactory placode.

p53 gene mutation was examined in 9 pineal parenchymal tumors, 4 pineoblastomas and 5 pineocytomas, by the immunohistochemical and the polymerase chain reaction-mediated single strand conformation polymorphism (PCR-SSCP) analyses. In each case, immunohistochemical analysis revealed no positive staining for p53 protein with either PAb1801 or DO-1 antibody and PCR-SSCP analysis revealed no abnormal migration in exons 5 to 8 of the p53 gene. These findings suggested that p53 gene mutation is rarely related with the tumorigenesis of pineal parenchymal tumors.

Six cases of pineocytoma, which had developed in the parenchyma of the adult pineal body, were examined immunohistochemically and under an electron microscope, after the malignancy of each case had been determined using our classification. One case was rated as grade 1 showing a lobular structure and resembling the normal pineal body. Two cases were rated as grade 2 without a lobular structure but with pineocytomatous rosettes (P-rosettes). Two cases were rated as grade 3 without P-rosettes but with few mitotic figures. One case was rated as grade 4 with marked cellular pleomorphism, numerous mitotic figures and necrotic foci. When examined immunohistochemically, neuron-specific enolase was positive but glial fibrillary acidic protein was negative in all cases. Under an electron microscope, all cases showed abortive synapses, and clear or dense core vesicles. These findings allow us to make two conclusions. First, pineocytoma is always a tumor of neuronal lineage, regardless of their grade of malignancy. Second, the grade 4 pineocytoma should be distinguished from the type of tumor classically called "pineoblastoma." That is, the former seems to be a biologically dedifferentiated tumor, while the latter seems to be biologically undifferentiated tumor.

This report demonstrates the detachment of desmosomes in the microcystic area of a frontal convexity meningioma removed from a 69-year-old woman. Well-developed interdigitations of the tumor cell processes with numerous desmosomes and with narrow extracellular spaces were characteristic features of the solid area of the meningioma. By contrast, the microcystic area of the tumor had markedly distended extracellular spaces. Various stages in the separation of desmosomal attachments were seen in this area. The observed configurations ranged from the widening of opposing junctions to the formation of large cavities where hemidesmosome-like structures were evident. The latter lacked basal lamina, and are considered to represent a transition leading to the loss of desmosome, and thus involved in the enlargement of the extracellular space in microcystic meningiomas.

A case of pigmented choroid plexus papilloma removed from the 4th ventricle of a 43-year-old man is reported. The tumor showed histologic, immunophenotypic, and ultrastructural features of neoplastic choroid plexus epithelium. There was no evidence of melanosomal activity or neurosecretion. The pigment consisted of an intimate association of lipofuscin and neuromelanin, indicating autocatalytic peroxydation of the former as a putative way of melaninogenesis. The low proliferation rate of the tumor together with immunohistochemical evidence of inactivation of p53 protein suggest a delayed turnover of neoplastic cells as a possible source of lipofuscin accumulation.

Histological study was undertaken on ciliated craniopharyngioma and Rathke cleft cyst, to know the origin of ciliated craniopharyngioma. Subjects were 7 cases with symptomatic Rathke cleft cysts and a ciliated craniopharyngioma. Light and electron microscopic observations were made on surgically resected specimens of the 8 cases. The ciliated craniopharyngioma was composed mainly of papillary type of craniopharyngioma and of dispersed ciliated columnar epithelium including goblet cells. Four cases with Rathke cleft cyst showed squamous metaplasia of which the basal cells were histologically similar to that of papillary type of craniopharyngioma. Other 3 cases of Rathke cleft cyst, basal cells were revealed to have tonofilaments and desmosomes. It seems possible that ciliated craniopharyngioma has derived from the basal cells of Rathke cleft epithelium.