Volume 27, No. 4/2008(July/August)
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 Clinical Neuropathology
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Tumor
Analysis of UbcH10 expression represents a useful tool for the diagnosis and therapy of astrocytic tumors
G. Donato, G. Iofrida, A. Lavano, G. Volpentesta, F. Signorelli, P.L. Pallante, M.T. Berlingieri, M.G. Pierantoni, D. Palmieri, F. Conforti, L. Maltese, L. Tucci, A. Amorosi and A. Fusco
Abstract
G. Donato1, G. Iofrida2, A. Lavano2, G. Volpentesta2, F. Signorelli2, P.L. Pallante3, M.T. Berlingieri3, M.G. Pierantoni3, D. Palmieri3, F. Conforti1, L. Maltese1, L. Tucci4, A. Amorosi1 and A. Fusco3
1Chair of Pathology, School of Medicine, University “Magna Graecia” of Catanzaro, 2Chair of Neurosurgery, School of Medicine, University “Magna Graecia” of Catanzaro, 3NOGEC (Naples Oncogenomic Center) CEINGE, Biotechnology, Avanzate-Napoli and SEMM European School of Molecular Medicine, 4Department of Pathology, General Hospital “A. Pugliese”, Catanzaro, Italy
Previous studies suggest the expression of UbcH10 gene, that codes for a protein belonging to the ubiquitin-conjugating enzyme family, as a valid indicator of the proliferative and aggressive status of tumors of different origin. Therefore, to look for possible tools to be used as diagnostic markers in astrocytic neoplasias, we investigated UbcH10 expression in normal brain, gliosis and low-grade and high-grade astrocytic tumors by immunohistochemistry. UbcH10 expression was observed in low-grade astrocytoma and in glioblastoma. Our data indicate a clear correlation between UbcH10 expression and the histological grade of the astrocytic tumors. Moreover, the analysis of UbcH10 expression allows the differentiation between gliotic and malignant tissues. Finally, since proteasome inhibitors have recently been considered as possible drugs in the chemotherapy of various tumors, our results would suggest new perspectives for the treatment of brain malignancies based on the suppression of the UbcH10 function.Correspondence to:
Giuseppe Donato, MD PhD; U.O. di Anatomia Patologica, Policlinico Mater Domini, Via T. Campanella, 88100 Catanzaro, Italy
Email: gdonato@unicz.it
Tumor
Different assessments of immunohistochemically stained Ki-67 and hTERT in glioblastoma multiforme yield variable results: A study with reference to survival prognosis
A. Persson and E. Englund
Abstract
A. Persson and E. Englund
Department of Clinical Science, Lund, Division V, Pathology, University Hospital, Lund, Sweden
Objective: To investigate a marker of tumor proliferation, Ki-67, and telomerase expression in glioblastoma multiforme and to compare the results of different mainly quantitative assessments, in relation to age and survival rates. Methods: Immunohistochemical stainings of Ki-67 and hTERT were evaluated in 39 formaldehyde-fixed, paraffin-embedded surgical samples of glioblastoma multiforme diagnosed during 2004, comprising all specimens with sufficient amount of vital tissue sent to the Department of Pathology during this year. Ki-67 counting and hTERT evaluation was assessed on whole tumor sections and on selected areas within each section. Age and length of survival were analyzed in relation to these parameters. Results: We found that different methods of evaluating the stained sections yielded different results regarding Ki-67, but less marked differences for hTERT. With Ki-67 counting on whole sections (non-selected areas), we found a statistically significant correlation with length of survival. There was no corresponding information in the hTERT assessment. We could also confirm a significant inverse correlation between age and length of survival, as previously published. Conclusion: Our data demonstrate that different methods of Ki-67 evaluation may give markedly dissimilar results. The significant correlation found between survival and one but not with two other methods of Ki-67 assessment, implicate the value of standardized quantification methods. Our data indicate a possible prognostic use of immunohistochemical Ki-67 proliferation index in glioblastoma multiforme.Correspondence to:
Dr. A. Persson; Department of Clinical Science, Lund, Division V, Pathology, University Hospital, 221 85 Lund, Sweden
Email: Annette.Persson@med.lu.se
Tumor
Temporal pleomorphic xanthoastrocytoma with glycogen accumulation – case report
F. Rogério, L. de Souza Queiroz, M.S.X. de Lima, P.R. Kaleff and A.A. Roth Vargas
Abstract
F. Rogério1, L. de Souza Queiroz1, M.S.X. de Lima2, P.R. Kaleff2 and A.A. Roth Vargas2
1Department of Pathology, School of Medical Sciences, State University of Campinas, UNICAMP and 2Service of Neurosurgery, Santa Casa de Limeira Hospital, Limeira, SP, Brazil
Pleomorphic xanthoastrocytoma (PXA) is a rare superficial glioma that predominates in the young and has good prognosis. A long history of repeated seizures is commonly associated with PXA, which is frequently observed in neuroimaging scans as a solid-cystic, contrast-enhancing lesion. We report a case in which PXA diagnosis was favored by its histological features, such as pleomorphic multinucleated giant cells, with disproportionately few mitoses and necrotic areas. An eye-catching feature was widespread, pale-staining, circumscribed deposits in the cytoplasm of tumor cells, which turned out to be glycogen upon histochemical and electron-microscopical examination. The stored material was strongly PAS-positive and digested by diastase, and had a finely granular ultrastructural appearance. No evidence of lipid droplets was found on oil-red-O staining. The tumor was immunoreactive for glial fibrillary acidic protein and vimentin. Many cells were positive for CD34 on the external membrane, a feature which has been described in chronic CNS lesions associated with epilepsy. Intracytoplasmic immunostaining for EGFR was observed in most tumor cells, which might have favored neoplastic proliferation. Nuclear immunolabeling for p53 protein was rare and does not support a major role for p53 mutation in PXA tumorigenesis. Intracellular accumulation of glycogen in glial tumors is uncommon and may originate from abnormalities in carbohydrate metabolic pathways.Correspondence to:
F. Rogério; Department of Pathology, School of Medical Sciences, State University of Campinas, UNICAMP, Brazil
Email: fabio@fcm.unicamp.br
Tumor
Granulocytic sarcoma in a patient with essential thrombocythemia presented as acute spinal cord compression – case report and review of the literature
M. Jerse, U. Mlakar, M. Popovic, A. Vranic and N. Zidar
Abstract
M. Jerse1, U. Mlakar2, M. Popovic1, A. Vranic3 and N. Zidar1
1Institute of Pathology, Medical Faculty, 2Department of Hematology and 3Department of Neurosurgery, University Medical Center Ljubljana, Slovenia
Granulocytic sarcoma (GS) is a rare solid tumor of myeloid origin, which usually precedes or occurs concurrently with myeloid leukemia, or with other types of myeloproliferative and myelodysplastic disorders. Spinal affections of GS have been described but are uncommon, particularly in association with essential thrombocythemia. We present a case of a 75-year-old woman with a long history of essential thrombocythemia who developed 2 tumors: 1 in the bodies of T3 – 6 vertebras extending epidurally, and the other in the right frontal lobe, adherent to dura, thus, mimicking meningioma. The patient died because of massive pulmonary thrombembolia. Microscopical and immunohistochemical features of spinal and intracranial tumor samples obtained at autopsy were consistent with the diagnosis of GS with focal megakaryocytic differentiation. Clinicians and pathologists should be aware of this rare tumor being so diverse in its clinical presentation, as well as in microscopical and immunohistochemical features. Careful evaluation of morphology, in conjunction with immunohistochemistry for evidence of myeloid differentiation are required to avoid frequent errors in diagnostics of GS. The suggested panel includes chloroacetate esterase, myeloperoxidase, lysozyme, CD117, CD43, CD79a and CD3. Only early correct diagnosis will enable proper treatment which may be successful despite the highly malignant potential of GS.Correspondence to:
M. Jerse, MD; Institute of Pathology, Medical Faculty, Korytkova 2, 1000 Ljubljana, Slovenia
Email: maja.jerse@mf.uni-lj.si
Tumor
Rhabdoid meningioma with cranial nerve involvement: case report of a child
S. Chaturvedi, R. Dua, S. Singhal and R. Kumari
Abstract
S. Chaturvedi1, R. Dua4, S. Singhal3 and R. Kumari2
1,3Department of Pathology, 2Department of Neuroradiology, 4Department of Neurosurgery,Institute of Human Behaviour and Allied Sciences, Guru Teg Bahadur Hospital, Delhi, India
Case report: A 13-year-old girl presented with off and on headache for 1 year, hearing loss for 6 months and difficulty in closing eyes for 5 months along with mild cerebellar signs. Histopathologic evaluation of the tumor showed a rhabdoid meningioma (WHO Grade III). Discussion: Rhabdoid meningiomas are uncommon in children, and only 4 cases have been reported so far. None of them presented with cranial nerve involvement. This unusual presentation is reported here. Conclusion: Though rare, rhabdoid meningiomas can occur in children. This, to the best of the authors’ knowledge, is the first case of rhabdoid meningioma presenting with cranial nerve involvement.Correspondence to:
Dr. S. Chaturvedi; E-15, GTB Hospital Campus, Dilshad Garden, Delhi-110 095, India
Email: cvsujata@hotmail.com
Tumor
Central neurocytoma with remarkably large rosette formation and rapid malignant progression: a clinicopathological follow-up study with autopsy report
M. Amagasa, F. Yuda, S. Sato and H. Kojima
Abstract
M. Amagasa1, F. Yuda2, S. Sato3 and H. Kojima4
1Department of Neurosurgery, Yamagata Tokushukai Hospital, 2Department of Pathology, Yamagata City Hospital Saiseikan, Yamagata, 3Department of Neurosurgery, Akaishi Hospital, Shiogama and 4Department of Clinical Neuropathology, Tokyo Metropolitan Institute for Neuroscience and Mitsubishi Chemical Medicine, Tokyo, Japan
Background: Small fibrillary areas mimicking neuropils are known to be one of the histological features of ordinary central neurocytomas. It is known that Ki-67 labeling indices are an indicator for prognosis of central neurocytomas. Case report: A tumor arising from the lateral ventricle of a 42-year-old man was almost completely resected. The mass resembled an aneurysm-like hematoma at the septum pellucidum. Histologically, the tumor mainly consisted of synaptophysin-positive small round cells displaying prominent rosette formation and calcification. The Ki-67 labeling index of the tumor was zero. Adjacent glial components were not neoplastic. Two years later, the tumor underwent meningeal dissemination. The patient died and an autopsy was performed. Histologically, proliferation of small round cells with a high Ki-67 labeling index was observed. Conclusion: In the present case, clinical tumor onset was marked by intracerebral hemorrhage. Rosette formation is a characteristic histological finding of neurocytic tumors including central neurocytomas. However, in the present case, rosette formation and calcification were remarkably prominent. In addition, this case demonstrates that malignant transformation may also occur in central neurocytomas that show very low initial Ki-67 labeling indices.Correspondence to:
Dr. M. Amagasa; Department of Neurosurgery, Yamagata Tokushukai Hospital, 2-3-51 Kiyozumi-machi Yamagata, 990-0834, Japan
Email: mamagasa@gmail.com
Abstracts
Joint Meeting</br>XLIV Congress of the Italian Association of Neuropathology (AINP)</br>XXXIV Congress of the Italian Association for Research on Brain Aging (AIRIC),</br>Milan, Italy, June 18 – 21, 2008
Local Organizing Committee: G. Forloni, F. Tagliavini, D. Albani, R. Bertazzi, M.G. De Simoni, M. Morbin and E. ScarpiniScientific Committee: AINP Board and AIRIC Board
Abstract
Local Organizing Committee: G. Forloni, F. Tagliavini, D. Albani, R. Bertazzi, M.G. De Simoni, M. Morbin and E. ScarpiniScientific Committee: AINP Board and AIRIC Board
Euro-CNS News
Society News of the European Confederation of Neuropathological Societies
Euro-CNS
