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Spinal intradural pseudocyst formation in central nervous system superficial siderosis 中枢神经系统浅层蛛网膜病形成脊髓硬膜内假性囊肿。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-09 DOI: 10.1111/bpa.13269
Kiyoshi Ito, Mitsunori Yamada, Kai Uehara, Yusuke Takahashi, Minori Kodaira, Yoshiki Sekijima, Yasuko Toyoshima, Akiyoshi Kakita, Kunihiko Makino, Hiroki Ohashi, Kazuhiro Hongo, Tetsuyoshi Horiuchi

The figure shows tissue samples taken from three previous cases, revealing the cause of hemosiderin deposition in the central nervous system because of superficial siderosis.

图中显示了从之前三个病例中提取的组织样本,揭示了中枢神经系统中血色素沉积的原因,即表皮蚕豆病。
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引用次数: 0
Fibrillar extracellular matrix produced by pericyte-like cells facilitates glioma cell dissemination 类周细胞产生的纤维细胞外基质有助于胶质瘤细胞扩散。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-05-05 DOI: 10.1111/bpa.13265
Petr Vymola, Elena Garcia-Borja, Jakub Cervenka, Eva Balaziova, Barbora Vymolova, Jana Veprkova, Petr Vodicka, Helena Skalnikova, Robert Tomas, David Netuka, Petr Busek, Aleksi Sedo

Gliomagenesis induces profound changes in the composition of the extracellular matrix (ECM) of the brain. In this study, we identified a cellular population responsible for the increased deposition of collagen I and fibronectin in glioblastoma. Elevated levels of the fibrillar proteins collagen I and fibronectin were associated with the expression of fibroblast activation protein (FAP), which is predominantly found in pericyte-like cells in glioblastoma. FAP+ pericyte-like cells were present in regions rich in collagen I and fibronectin in biopsy material and produced substantially more collagen I and fibronectin in vitro compared to other cell types found in the GBM microenvironment. Using mass spectrometry, we demonstrated that 3D matrices produced by FAP+ pericyte-like cells are rich in collagen I and fibronectin and contain several basement membrane proteins. This expression pattern differed markedly from glioma cells. Finally, we have shown that ECM produced by FAP+ pericyte-like cells enhances the migration of glioma cells including glioma stem-like cells, promotes their adhesion, and activates focal adhesion kinase (FAK) signaling. Taken together, our findings establish FAP+ pericyte-like cells as crucial producers of a complex ECM rich in collagen I and fibronectin, facilitating the dissemination of glioma cells through FAK activation.

胶质瘤的发生会引起脑细胞外基质(ECM)成分的深刻变化。在这项研究中,我们发现了胶质母细胞瘤中胶原蛋白 I 和纤连蛋白沉积增加的细胞群。纤维蛋白胶原 I 和纤维粘连蛋白水平的升高与成纤维细胞活化蛋白(FAP)的表达有关,而成纤维细胞活化蛋白主要存在于胶质母细胞瘤的类包膜细胞中。FAP+ 包膜样细胞存在于活检材料中富含胶原 I 和纤连蛋白的区域,与 GBM 微环境中发现的其他细胞类型相比,它们在体外产生的胶原 I 和纤连蛋白要多得多。通过质谱分析,我们证明了 FAP+ 包膜样细胞产生的三维基质富含胶原蛋白 I 和纤连蛋白,并含有多种基底膜蛋白。这种表达模式与胶质瘤细胞明显不同。最后,我们发现 FAP+周细胞样细胞产生的 ECM 可增强胶质瘤细胞(包括胶质瘤干样细胞)的迁移,促进其粘附,并激活局灶粘附激酶(FAK)信号传导。综上所述,我们的研究结果表明,FAP+周细胞样细胞是富含胶原蛋白I和纤连蛋白的复杂ECM的重要生产者,通过激活FAK促进胶质瘤细胞的扩散。
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引用次数: 0
A role for vessel-associated extracellular matrix proteins in multiple sclerosis pathology 血管相关细胞外基质蛋白在多发性硬化病理学中的作用。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-25 DOI: 10.1111/bpa.13263
Marco Pisa, Joseph L. Watson, Jonathan I. Spencer, Guy Niblett, Yasamin Mahjoub, Andrew Lockhart, Richard L. Yates, Sydney A. Yee, Gina Hadley, Jennifer Ruiz, Margaret M. Esiri, Benedict Kessler, Roman Fischer, Gabriele C. DeLuca

Multiple sclerosis (MS) is unsurpassed for its clinical and pathological hetherogeneity, but the biological determinants of this variability are unknown. HLA-DRB1*15, the main genetic risk factor for MS, influences the severity and distribution of MS pathology. This study set out to unravel the molecular determinants of the heterogeneity of MS pathology in relation to HLA-DRB1*15 status. Shotgun proteomics from a discovery cohort of MS spinal cord samples segregated by HLA-DRB*15 status revealed overexpression of the extracellular matrix (ECM) proteins, biglycan, decorin, and prolargin in HLA-DRB*15-positive cases, adding to established literature on a role of ECM proteins in MS pathology that has heretofore lacked systematic pathological validation. These findings informed a neuropathological characterisation of these proteins in a large autopsy cohort of 41 MS cases (18 HLA-DRB1*15-positive and 23 HLA-DRB1*15-negative), and seven non-neurological controls on motor cortical, cervical and lumbar spinal cord tissue. Biglycan and decorin demonstrate a striking perivascular expression pattern in controls that is reduced in MS (−36.5%, p = 0.036 and − 24.7%, p = 0.039; respectively) in lesional and non-lesional areas. A concomitant increase in diffuse parenchymal accumulation of biglycan and decorin is seen in MS (p = 0.015 and p = 0.001, respectively), particularly in HLA-DRB1*15-positive cases (p = 0.007 and p = 0.046, respectively). Prolargin shows a faint parenchymal pattern in controls that is markedly increased in MS cases where a perivascular deposition pattern is observed (motor cortex +97.5%, p = 0.001; cervical cord +49.1%, p = 0.016). Our findings point to ECM proteins and the vascular interface playing a central role in MS pathology within and outside the plaque area. As ECM proteins are known potent pro-inflammatory molecules, their parenchymal accumulation may contribute to disease severity. This study brings to light novel factors that may contribute to the heterogeneity of the topographical variation of MS pathology.

多发性硬化症(MS)的临床和病理异质性无与伦比,但这种变异性的生物学决定因素尚不清楚。HLA-DRB1*15是多发性硬化症的主要遗传风险因素,影响着多发性硬化症病理的严重程度和分布。本研究旨在揭示多发性硬化症病理异质性与 HLA-DRB1*15 状态相关的分子决定因素。从按 HLA-DRB*15 状态分类的 MS 脊髓样本发现队列中进行的射枪蛋白质组学研究发现,在 HLA-DRB*15 阳性病例中,细胞外基质(ECM)蛋白、biglycan、decorin 和 prolargin 表达过高,这补充了有关 ECM 蛋白在 MS 病理中的作用的文献,而这种作用迄今为止还缺乏系统的病理验证。这些发现为对 41 例多发性硬化症病例(18 例 HLA-DRB1*15 阳性,23 例 HLA-DRB1*15 阴性)和 7 例非神经病学对照组的运动皮质、颈椎和腰椎脊髓组织进行神经病理学特征描述提供了依据。对照组中 Biglycan 和 decorin 的血管周围表达模式非常明显,而多发性硬化症病变区和非病变区的血管周围表达模式则有所减少(分别为-36.5%,p = 0.036 和-24.7%,p = 0.039)。在多发性硬化症中,biglycan 和 decorin 的弥漫性实质积聚同时增加(分别为 p = 0.015 和 p = 0.001),尤其是在 HLA-DRB1*15 阳性病例中(分别为 p = 0.007 和 p = 0.046)。前列腺素在对照组中显示出微弱的实质形态,而在多发性硬化病例中则明显增加,观察到血管周围沉积形态(运动皮层 +97.5%,p = 0.001;颈索 +49.1%,p = 0.016)。我们的研究结果表明,ECM 蛋白和血管界面在斑块区域内外的多发性硬化病理中发挥着核心作用。由于 ECM 蛋白是已知的强效促炎分子,它们在实质组织中的积累可能会导致疾病的严重程度。这项研究揭示了可能导致多发性硬化症病理地形变化异质性的新因素。
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引用次数: 0
Cell redistribution of G quadruplex-structured DNA is associated with morphological changes of nuclei and nucleoli in neurons during tau pathology progression 在tau病理学发展过程中,G四倍体结构DNA的细胞再分布与神经元细胞核和核小体的形态变化有关。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-22 DOI: 10.1111/bpa.13262
Thomas Comptdaer, Meryem Tardivel, Claire Schirmer, Luc Buée, Marie-Christine Galas

While the double helical structure has long been its iconic representation, DNA is structurally dynamic and can adopt alternative secondary configurations. Specifically, guanine-rich DNA sequences can fold in guanine quadruplexes (G4) structures. These G4 play pivotal roles as regulators of gene expression and genomic stability, and influence protein homeostasis. Despite their significance, the association of G4 with neurodegenerative diseases such as Alzheimer's disease (AD) has been underappreciated. Recent findings have identified DNA sequences predicted to form G4 in sarkosyl-insoluble aggregates from AD brains, questioning the involvement of G4-structured DNA (G4 DNA) in the pathology. Using immunofluorescence coupled to confocal microscopy analysis we investigated the impact of tau pathology, a hallmark of tauopathies including AD, on the distribution of G4 DNA in murine neurons and its relevance to AD brains. In healthy neurons, G4 DNA is detected in nuclei with a notable presence in nucleoli. However, in a transgenic mouse model of tau pathology (THY-Tau22), early stages of the disease exhibit an impairment in the nuclear distribution of G4 DNA. In addition, G4 DNA accumulates in the cytoplasm of neurons exhibiting oligomerized tau and oxidative DNA damage. This altered distribution persists in the later stage of the pathology when larger tau aggregates are present. Still cytoplasmic deposition of G4 DNA does not appear to be a critical factor in the tau aggregation process. Similar patterns are observed in neurons from the AD cortex. Furthermore, the disturbance in G4 DNA distribution is associated with various changes in the size of neuronal nuclei and nucleoli, indicative of responses to stress and the activation of pro-survival mechanisms. Our results shed light on a significant impact of tau pathology on the dynamics of G4 DNA and on nuclear and nucleolar mechanobiology in neurons. These findings reveal new dimensions in the etiopathogenesis of tauopathies.

虽然双螺旋结构长期以来一直是其标志性代表,但 DNA 在结构上是动态的,可以采用其他二级构型。具体来说,富含鸟嘌呤的 DNA 序列可以折叠成鸟嘌呤四重(G4)结构。这些 G4 作为基因表达和基因组稳定性的调节因子发挥着关键作用,并影响着蛋白质的平衡。尽管G4具有重要意义,但其与阿尔茨海默病(AD)等神经退行性疾病的关系却一直未得到足够重视。最近的研究发现,在来自阿尔茨海默病大脑的 sarkosyl 不溶性聚集体中发现了预测会形成 G4 的 DNA 序列,从而对 G4 结构 DNA(G4 DNA)参与病理过程提出了质疑。利用免疫荧光和共聚焦显微镜分析,我们研究了tau病理学(包括AD在内的tau病的特征)对小鼠神经元中G4 DNA分布的影响及其与AD大脑的相关性。在健康神经元中,G4 DNA可在细胞核中检测到,并明显存在于核小体中。然而,在tau病理的转基因小鼠模型(THY-Tau22)中,疾病的早期阶段表现出G4 DNA的核分布障碍。此外,G4 DNA会在神经元的细胞质中积累,表现出tau低聚物和氧化性DNA损伤。在病理后期,当出现较大的 tau 聚合体时,这种分布改变仍会持续。G4 DNA在细胞质中的沉积似乎仍然不是tau聚集过程中的关键因素。在AD大脑皮层的神经元中也观察到了类似的模式。此外,G4 DNA分布的紊乱还与神经元细胞核和核小体大小的各种变化有关,这表明了对压力的反应和促生存机制的激活。我们的研究结果揭示了 tau 病理学对 G4 DNA 动态以及神经元核和核小体机械生物学的重大影响。这些发现揭示了tau病因发病机制的新层面。
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引用次数: 0
Correction to “A 4-year-old boy with a ventricular mass” 更正为 "一名患有心室肿块的 4 岁男孩"。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-22 DOI: 10.1111/bpa.13266

Zhou, J, Qu, K, Lv, M, Gao, Y, Zhang, L, Duan, L, et al. A 4-year-old boy with a ventricular mass. Brain Pathology. 2022; 32(5):e13081. https://doi.org/10.1111/bpa.13081

Figure 1 of this article has been published in another article shortly before by a different group of authors from the same institute elsewhere [1]. The authors have confirmed that they had access to the MR images and the histology results of their study from the hospitals public database and were not aware of the other group's publication. Although both articles describe the same patient, and partially overlapping results, yet the content is sufficiently different not to be considered redundant.

The authors have obtained retrospective permission for the reproduction of this image from the Chinese Journal of Contemporary Neurology & Neurosurgery. The updated caption of Figure 1 with the copyright statement is as follows:

FIGURE 1 Axial T1-weighted contrast enhanced magnetic resonance imaging shows the low intensity mass was located on the front edge of the right brain ventricle, with a few darker strands and no enhancement (arrowhead). Reprinted with permission, Copyright 2022, Chinese Journal of Contemporary Neurology & Neurosurgery [1].

The authors also wished to make a correction to the affiliation of the co-authors, Kexuan Qu and Mengxing Lv.

The correct affiliation is: Department of Pathology, Kunming Children's Hospital, Kunming, P.R. China and Department of Blood Transfusion, Kunming Children's Hospital, Kunming, P. R. China

Zhou,J,Qu,K,Lv,M,Gao,Y,Zhang,L,Duan,L,et al.一名患有脑室肿块的 4 岁男孩。脑病理学 2022;32(5):e13081。https://doi.org/10.1111/bpa.13081 本文的图1不久前已由同一研究所的另一组作者发表在另一篇文章中[1]。作者证实,他们可以从医院的公共数据库中获取他们研究的磁共振图像和组织学结果,并不知道另一组作者发表了这篇文章。虽然两篇文章描述的是同一名患者,结果也有部分重叠,但两篇文章的内容差异很大,不属于重复研究。作者已获得《中国当代神经病学杂志》(Chinese Journal of Contemporary Neurology & Neurosurgery)的追溯许可,可以转载本图片。更新后的图 1 标题及版权声明如下:图 1 轴位 T1 加权对比增强磁共振成像显示,低强度肿块位于右侧脑室前缘,有少数暗色条索,无强化(箭头所指)。经授权转载,《中国当代神经病学杂志》版权所有,2022 年[1]。作者还希望对共同作者曲克宣和吕梦醒的单位进行更正:中国昆明市儿童医院病理科和中国昆明市儿童医院输血科
{"title":"Correction to “A 4-year-old boy with a ventricular mass”","authors":"","doi":"10.1111/bpa.13266","DOIUrl":"10.1111/bpa.13266","url":null,"abstract":"<p>\u0000 <span>Zhou, J</span>, <span>Qu, K</span>, <span>Lv, M</span>, <span>Gao, Y</span>, <span>Zhang, L</span>, <span>Duan, L</span>, et al. <span>A 4-year-old boy with a ventricular mass</span>. <i>Brain Pathology.</i> <span>2022</span>; <span>32</span>(<span>5</span>):e13081. https://doi.org/10.1111/bpa.13081\u0000 </p><p>Figure 1 of this article has been published in another article shortly before by a different group of authors from the same institute elsewhere [<span>1</span>]. The authors have confirmed that they had access to the MR images and the histology results of their study from the hospitals public database and were not aware of the other group's publication. Although both articles describe the same patient, and partially overlapping results, yet the content is sufficiently different not to be considered redundant.</p><p>The authors have obtained retrospective permission for the reproduction of this image from the Chinese Journal of Contemporary Neurology &amp; Neurosurgery. The updated caption of Figure 1 with the copyright statement is as follows:</p><p><b>FIGURE 1</b> Axial T1-weighted contrast enhanced magnetic resonance imaging shows the low intensity mass was located on the front edge of the right brain ventricle, with a few darker strands and no enhancement (arrowhead). Reprinted with permission, Copyright 2022, Chinese Journal of Contemporary Neurology &amp; Neurosurgery [<span>1</span>].</p><p>The authors also wished to make a correction to the affiliation of the co-authors, Kexuan Qu and Mengxing Lv.</p><p>The correct affiliation is: Department of Pathology, Kunming Children's Hospital, Kunming, P.R. China and Department of Blood Transfusion, Kunming Children's Hospital, Kunming, P. R. China</p>","PeriodicalId":9290,"journal":{"name":"Brain Pathology","volume":"34 5","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bpa.13266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Detection of pTDP-43 via routine muscle biopsy: A promising diagnostic biomarker for amyotrophic lateral sclerosis 通过常规肌肉活检检测 pTDP-43:有望成为肌萎缩性脊髓侧索硬化症的诊断生物标志物
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-11 DOI: 10.1111/bpa.13261
Qi-Jie Zhang, Jie Lin, You-Liang Wang, Long Chen, Ying Ding, Fu-Ze Zheng, Huan-Huan Song, Ao-Wei Lv, Yu-Ying Li, Qi-Fu Guo, Min-Ting Lin, Wei Hu, Liu-Qing Xu, Wen-Long Zhao, Ling Fang, Meng-Chao Cui, Zhi-Fei Fu, Wan-Jin Chen, Jing Zhang, Zhi-Qiang Wang, Ning Wang, Ying Fu

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease, pathologically characterized by TDP-43 aggregates. Recent evidence has been indicated that phosphorylated TDP-43 (pTDP-43) is present not only in motor neurons but also in muscle tissues. However, it is unclear whether testing pTDP-43 aggregation in muscle tissue would assist in the diagnosis of ALS. We propose three key questions: (i) Is aggregation of pTDP-43 detectable in routine biopsied muscles? (ii) Can detection of pTDP-43 aggregation discriminate between ALS and non-ALS patients? (iii) Can pTDP-43 aggregation be observed in the early stages of ALS? We conducted a diagnostic study comprising 2 groups: an ALS group in which 18 cases underwent muscle biopsy screened from a registered ALS cohort consisting of 802 patients and a non-ALS control group, in which we randomly selected 54 muscle samples from a biospecimen bank of 684 patients. Among the 18 ALS patients, 3 patients carried pathological GGGGCC repeats in the C9ORF72 gene, 2 patients carried SOD1 mutations, and 7 patients were at an early stage with only one body region clinically affected. The pTDP-43 accumulation could be detected in routine biopsied muscles, including biceps brachii, deltoid, tibialis anterior, and quadriceps. Abnormal aggregation of pTDP-43 was present in 94.4% of ALS patients (17/18) compared to 29.6% of non-ALS controls (16/54; p < 0.001). The pTDP-43 aggregates were mainly close to the sarcolemma. Using a semi-quantified pTDP-43 aggregates score, we applied a cut-off value of 3 as a diagnostic biomarker, resulting in a sensitivity of 94.4% and a specificity of 83.3%. Moreover, we observed that accumulation of pTDP-43 occurred in muscle tissues prior to clinical symptoms and electromyographic lesions. Our study provides proof-of-concept for the detection of pTDP-43 accumulation via routine muscle biopsy which may serve as a novel biomarker for diagnosis of ALS.

肌萎缩性脊髓侧索硬化症(ALS)是一种破坏性神经退行性疾病,病理特征为 TDP-43 聚集。最近有证据表明,磷酸化 TDP-43(pTDP-43)不仅存在于运动神经元中,也存在于肌肉组织中。然而,目前还不清楚检测肌肉组织中的 pTDP-43 聚集是否有助于 ALS 的诊断。我们提出了三个关键问题:(i) 在常规活检的肌肉中能否检测到 pTDP-43 的聚集? (ii) pTDP-43 聚集的检测能否区分 ALS 和非 ALS 患者?(iii) 能否在 ALS 早期阶段观察到 pTDP-43 聚集?我们进行了一项诊断研究,包括两组:一组是 ALS 组,其中 18 例接受了肌肉活检,这些肌肉活检是从由 802 例 ALS 患者组成的注册 ALS 队列中筛选出来的;另一组是非 ALS 对照组,我们从 684 例患者的生物样本库中随机抽取了 54 份肌肉样本。在18例ALS患者中,3例患者的C9ORF72基因中存在病理GGGGCC重复序列,2例患者的SOD1基因发生突变,7例患者处于早期阶段,只有一个身体区域受到临床影响。在常规活检的肌肉中,包括肱二头肌、三角肌、胫骨前肌和股四头肌,均可检测到 pTDP-43 的聚集。94.4%的肌萎缩性脊髓侧索硬化症患者(17/18)出现 pTDP-43 异常聚集,而非肌萎缩性脊髓侧索硬化症对照组中只有 29.6%的患者(16/54;p < 0.001)出现这种异常聚集。pTDP-43 聚集体主要靠近肌浆膜。我们使用半量化的 pTDP-43 聚集体评分,将 3 作为诊断生物标志物的临界值,结果灵敏度为 94.4%,特异性为 83.3%。此外,我们还观察到 pTDP-43 在临床症状和肌电图病变出现之前就已在肌肉组织中聚集。我们的研究为通过常规肌肉活检检测 pTDP-43 的积累提供了概念验证,它可作为诊断 ALS 的新型生物标记物。
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引用次数: 0
Society News 社会新闻
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-10 DOI: 10.1111/bpa.13257
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引用次数: 0
A supratentorial mass in a young adult, with 25 years of follow-up 一名年轻成年人的脑室上肿块,随访 25 年
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-10 DOI: 10.1111/bpa.13260
Francesca Baciorri, Samantha Sarcognato, Francesco Di Paola, Evelina Miele, Sabrina Rossi
<p>A 32-year-old male presented with a history of recent onset headaches. Imaging with magnetic resonance revealed a left parietal mass that showed heterogeneous gadolinium contrast enhancement, mild perilesional edema, and a small cystic component (Figure 1). The patient underwent surgical excision, with a complete resection of the mass. No adjuvant therapies were administered. Periodic follow-up magnetic resonance imaging did not show disease recurrence, and the patient is currently disease-free 25 years after the diagnosis (Box 1).</p><p>Histopathological examination showed a well-demarcated hypercellular neoplasm, with a multinodular growth, a rich vascular network, and perivascular paucicellular zones. The neoplastic cells displayed moderate nuclear atypia and diffuse lipomatous differentiation, which consisted of single large cytoplasmic vacuoles pushing the nuclei to the periphery of the cells, giving a signet ring appearance (Figure 2). The mitotic count reached 4 mitotic figures per 10 high-power fields, and necrosis and microvascular proliferation were absent.</p><p>By immunohistochemistry, the cells showed immunoreactivity for glial fibrillary acidic protein, S100, and focal dot-like cytoplasmic positivity for epithelial membrane antigen. Ki-67 labeling index was 10%. Electron microscopy was performed and revealed the presence of complex zipper-like intercellular junctions and microvilli, typical of ependymal differentiation (Figure 2). Twenty-five years later, the case was re-evaluated with additional immunostains and molecular analyses. The tumor proved positive for p65 and L1CAM, consistent with the diagnosis of supratentorial ependymoma, ZFTA fusion-positive (ST-EPN-ZFTA). While we failed to obtain good quality RNA for gene fusion investigation, we were able to perform DNA methylation analysis (Epic Illumina) on the original samples. In agreement with the pathological and immunohistochemical findings, the lesion classified as a ST-EPN-ZFTA (score 0.62), subtype A (score 0.58, DKFZ Classifier version v12.5). The copy number variation (CNV) profile obtained from DNA methylation analysis showed considerable background noise likely due to the age of the material; nevertheless, loss of chromosomes 9 and 22 was clearly observed (Figure 2).</p><p>Back in the days, a diagnosis of ependymoma with lipomatous differentiation, grade II, was made with the support of morphology, immunohistochemistry, and electron microscopy. After 25 years, the addition of new immunohistochemical markers and the DNA methylation profile confirmed the diagnosis and led to a more accurate definition of the lesion as a ST-EPN-ZFTA with diffuse lipomatous differentiation, grade 2.</p><p>We herein describe a case of ST-EPN-ZFTA with lipomatous differentiation arising in a young adult who did not show any recurrence over a follow-up period of 25 years. Lipomatous differentiation is described in a few central nervous system (CNS) tumors, such as medulloblastomas, centra
方框 1. 虚拟玻璃载玻片访问:https://isn-slidearchive.org/?col=ISN&fol=Archive&file=BPA-24-02-CI-040.svs
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引用次数: 0
A comprehensive histomolecular characterization of meningioangiomatosis: Further evidence for a precursor neoplastic lesion 脑膜血管瘤病的综合组织分子特征:前体肿瘤病变的进一步证据
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-04-02 DOI: 10.1111/bpa.13259
Arnault Tauziède-Espariat, Julien Masliah-Planchon, Philipp Sievers, Felix Sahm, Volodia Dangouloff-Ros, Nathalie Boddaert, Lauren Hasty, Oumaima Aboubakr, Alice Métais, Fabrice Chrétien, Alexandre Roux, Johan Pallud, Thomas Blauwblomme, Kévin Beccaria, Franck Bourdeaut, Stéphanie Puget, Pascale Varlet

Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or tumoral nature is still debated. Because a subset of MAM are associated with meningiomas, some authors argue that MAM corresponds to an infiltration pattern of these tumors. For these reasons, MAM has not been added to the World Health Organization (WHO) Classification of Central Nervous System Tumors as a specific entity. In the present study, we characterized a series of pure MAM (n = 7) and MAM associated with meningiomas (n = 4) using histopathology, immunohistochemistry, genetic (fluorescent in situ and DNA sequencing analyses), and epigenetic (DNA-methylation profiling) data. We evidenced two distinct morphological patterns: MAM with a fibroblastic-like pattern having few lesional cells, and MAM with a more cellular pattern. A subset was associated with the genetic alterations previously reported in meningiomas (such as a KMT2C mutation and a hemizygous deletion of chromosome 22q including the NF2 gene). The DNA-methylation profile, using a t-distributed stochastic neighbor embedding analysis, evidenced that MAM (pure or associated with meningiomas) clustered in a separate group from pediatric meningiomas. The present results seem to suggest that MAM represents a neoplastic lesion and encourage the further study of similar additional series so that it may be included in a future WHO classification.

脑膜血管瘤病(MAM)是一种引起癫痫疾病的病变,但人们对其了解甚少。过去,脑膜血管瘤病主要是在神经纤维瘤病 2 型的背景下被描述的,后来才主要被零星报道。此外,对其性质是畸形还是肿瘤仍存在争议。由于一部分 MAM 与脑膜瘤相关,一些学者认为 MAM 与这些肿瘤的浸润模式相对应。由于这些原因,世界卫生组织(WHO)的《中枢神经系统肿瘤分类》尚未将 MAM 列入一个特定的实体。在本研究中,我们利用组织病理学、免疫组化、遗传学(荧光原位和DNA测序分析)和表观遗传学(DNA甲基化分析)数据,对一系列纯MAM(7例)和与脑膜瘤相关的MAM(4例)进行了鉴定。我们发现了两种不同的形态模式:MAM具有纤维母细胞样模式,病变细胞较少,而MAM则具有更多的细胞模式。其中一个子集与之前报道的脑膜瘤基因改变(如 KMT2C 基因突变和包括 NF2 基因在内的 22q 染色体半杂合子缺失)有关。采用 t 分布随机邻位嵌入分析法进行的 DNA 甲基化分析表明,MAM(单纯脑膜瘤或伴发脑膜瘤)与小儿脑膜瘤分属不同组别。本研究结果似乎表明,MAM 是一种肿瘤性病变,因此鼓励对类似的其他系列病变进行进一步研究,以便将其纳入未来的世界卫生组织分类中。
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引用次数: 0
A mass in the pineal region of a young woman 一名年轻女性的松果体区域出现肿块。
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-03-25 DOI: 10.1111/bpa.13258
Lorraina J. Robinson, Eric Goold, David Anderson, Robert C. Rennert, William T. Couldwell, Changhong Xing
<p>This case involves an 18-year-old female with no significant past medical history who was found to have a large pineal and third ventricular tumor with obstructive hydrocephalus after experiencing subacute, progressive headaches, and an acute episode of sudden vision loss. She underwent a ventriculoperitoneal shunt at an outside facility with improvement in her vision before presenting as a transfer to our facility. Brain magnetic resonance imaging upon transfer demonstrated a large, heterogenous enhancing mass (6.6 × 6.1 × 5.7 cm) centered in the pineal region with extension into the third and right lateral ventricles (Figure 1). The tumor exerted mass effect by splaying the bilateral thalami with effacement of the basal cisterna, effacement of the cerebral aqueduct, and an 8 mm tonsillar herniation. Surgery was pursued for a definitive diagnosis and tumor debulking. Intraoperatively, the tumor demonstrated variable soft and firm consistency with moderate vascularity. Post-operative imaging did not demonstrate clear residual tumor. She was discharged with no new neurologic deficits.</p><p>Histology of H&E-stained sections demonstrated a moderately hypercellular neoplasm consisting of an admixture of small to medium-sized spindle cells embedded in a heavily collagenized and myxoid matrix (Box 1, Figure 2A, B). Tumor cells were observed forming disorganized, haphazard architectural patterns while some tumor cells were seen floating in a loose basophilic myxoid matrix (Figure 2A). The mitotic index was <1/10 high-power-fields. Necrosis was absent. By immunohistochemistry, the tumor cells were patchy positive for CD163 (Figure 2C) and CD99 (Figure 2D), focally positive for desmin (Figure 2D inset), and negative for GFAP, OLIG2, CD34, and SSTR2. MIB-1 proliferation index was overall low (1%–2%) (Figure 2E) but focally increased at approximately 10% (Figure 2E inset). Immunostaining for SMARCB1 showed loss of expression in many of the tumor cells (Figure 2F).</p><p>NeoTYPE brain tumor profile (DNA and RNA) from NeoGenomics was performed, and no pathogenic mutations or fusions were detected. However, a variant of unknown clinical significance involving the <i>SMARCB1</i> gene c.91G>A (p.Glu31Lys) E31K NM_003073.5:c.91G>A was detected. Whole genome methylation profiling was performed at the National Institute of Health (NIH)/National Cancer Institute (NCI) for confirmation of the diagnosis. The composite NIH/NCI methylation profile classified the tumor with a high confidence score (0.99) as a desmoplastic myxoid tumor, <i>SMARCB1</i>-altered.</p><p>Desmoplastic myxoid tumor (DMT) of the pineal region, <i>SMARCB1</i>-mutant.</p><p>As defined by the most recent 2021 World Health Organization (WHO) Central Nervous System tumor classification, DMT of the pineal region, <i>SMARCB1</i>-mutant, maintains a unique <i>SMARCB1</i>-mutation while histologically displaying desmoplasia and myxoid changes but lacking histopathological signs of maligna
E31K已在测序研究中发现(PMID:33845210,PMID:37649695),但尚未进行生化鉴定,因此其对SMARCB1蛋白功能的影响尚不清楚:临床数据收集:LR、EG、DA、RR、WC 和 CX。图表和手稿文本准备:LR、RR、EG、DA、RR、WC 和 CX:临床数据收集:LR、EG、DA、RR、WC 和 CX。研究监督:CX:CX。所有作者均对研究构思或数据的获取、分析或解释做出了重要贡献。所有作者均审阅并批准了最终手稿。
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Brain Pathology
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