1/16. Squash cytology of pleomorphic xanthoastrocytoma mimicking glioblastoma. A case report.BACKGROUND: Pleomorphic xanthoastrocytoma (PXA) is an uncommon, superficially located and well-circumscribed brain tumor that originates in astrocytic cells. Despite the fact that the tumor cells are pleomorphic, with bizarre nuclei, the clinical course is favorable. Cytologic and histologic differentiation from other high grade gliomas is necessary to determine adequate therapy during surgery. Cytomorphologic features of this tumor have been described only rarely. CASE: A 22-year-old male had complained of visual disturbance for about a year. Radiologic imaging revealed a well-circumscribed mass with cyst formation in the left temporal area. Squash specimens from fresh tissues were highly cellular. Tumor cells were markedly pleomorphic, with long and coarse cytoplasmic processes showing a fibrillary astrocytic appearance. Pleomorphic cells varied in shape from round to elongated and had large, multilobed, hyperchromatic nuclei but few nuclear mitoses. Sometimes eosinophilic granular bodies were also observed. blood vessels were found frequently in tumor cell clusters, but their endothelium was not swollen. In the background, considerable leukocytic infiltration, but no cellular debris, was observed. With immunohistochemical studies, most of the tumor cells were positive for glial fibrillary acidic protein and S-100 protein. Some of the mononuclear giant cells were positive for synaptophysin. CONCLUSION: Squash preparations showed the peculiar cytologic features of PXA. Together with the peculiar radiologic findings, the cytologic results make it possible to render a diagnosis of PXA.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/16. Cerebral vasculopathy secondary to leptomeningeal gliomatosis: angiography.We describe a young woman with a glioblastoma multiforme in whom angiography showed multiple intracranial stenoses. The resected tumour was found to be invading cerebral vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/16. Immunohistochemical tenascin-C expression in paediatric supratentorial glioblastoma multiforme.tenascin-C (TN-C) plays an important part in the growth of neoplastic tissue, leading to new vessel development. TN-C has been assessed in adult glioblastoma multiforme (GBM) and has been evaluated as anti-neoplastic therapy. No studies have focused on this tissue in paediatric GBM. tissues were obtained from six paediatric supratentorial GBMs. immunohistochemistry was performed using a mouse antibody directed against human TN-C, and expression in tumour vasculature was described on the basis of TN-C immunoreactivity. The expression was minimal in three, moderate in two, and intense in one specimen. TN-C was not correlated with clinical history, neurological findings, or with tumour site. Although based on a limited number of patients, this study provides additional insights into tumour growth modulation and cytogenetic profile of paediatric GBM. The detailed understanding of events responsible for GBM growth is a prerequisite for the development of therapeutic modalities leading to improved prognosis and cure.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/16. Biologic characterization of a secondary glioblastoma with extracranial progression and systemic metastasis.Glioblastomas rarely metastasize outside the CNS. We biologically characterized a case of secondary glioblastoma associated with extracranial progression and distant metastasis. A 42-year-old male patient was subjected to craniotomy for a left temporal tumor (astrocytoma grade II) and subsequently underwent another 3 craniotomies due to tumor recurrences. At the third craniotomy, extracranial progression was noted, and the tumor was classified as a glioblastoma. In order to pinpoint the genes expressed differentially in the intracranial primary tumor and the metastatic tumors, we used cDNA microarray. The patterns of gene expression in these 2 samples were highly similar, suggesting that the mechanism of metastasis was direct infiltration of tumor cells into extracranial blood vessels. insulin-like growth factor binding protein-2 was overexpressed in both primary and metastatic tumors. Immunohistochemical studies of dna-dependent protein kinase, which participates in the repair of dna, was strongly positive in the samples obtained at the first and second operations, but the positive rates were markedly reduced in the specimens obtained at the third and fourth operations. These results suggest that insulin-like growth factor binding protein-2 and deficiency of dna-dependent protein kinase proteins promoted tumor progression in the present case.- - - - - - - - - - ranking = 12.735064369455keywords = blood vessel, vessel (Clic here for more details about this article) |
5/16. Susceptibility-based imaging of glioblastoma microvascularity at 8 T: correlation of MR imaging and postmortem pathology.BACKGROUND AND PURPOSE: Imaging methods are currently being optimized in an attempt to assess and monitor angiogenesis in vivo. The purpose of this investigation was to determine whether areas of apparently increased tumor vascularity, as identified on 8-T gradient-echo (GE) imaging of a known glioblastoma multiforme (GBM), corresponds to foci of increased microvascularity on histopathologic analysis. methods: We performed postmortem in situ, high-resolution GE 8-T MR imaging of the brain in a 53-year-old woman with GBM. Ten histopathologic specimens in the region of the tumor bed were studied by using hematoxylin-eosin and reticulin stains. MR and histopathologic results were assessed and compared for microvascular size and density. RESULTS: 8-T GE images showed small, penetrating vessels in the gray matter and white matter. The images, however, were partly inhomogeneous as a result of local magnetic field inhomogeneities adjacent to the skull base and aerated paranasal sinus structures. 8-T MR images demonstrated serpiginous areas of signal intensity loss, which were thought to represent areas of increased microvascularity. Areas of lower microvascularity in the tumor bed corresponded to areas of lower vascularity on histopathologic sections with smaller vessel diameters. There was concurrence between vascular size predicted by histopathologic analysis and 8-T MR imaging in nine of nine biopsy samples. Vascular density agreed in seven of nine biopsy samples. CONCLUSION: Our pilot data suggest that microvascularity in GBM can be identified by use of high-resolution, GE, 8-T MR imaging.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/16. Endovascular management of traumatic and iatrogenic aneurysms of the pericallosal artery. Report of two cases.Traumatic intracranial aneurysms are rare complications of closed and penetrating head injuries and may also be related to a variety of neurosurgical procedures. The primary goals in the treatment of patients harboring these lesions are early identification and intervention to prevent bleeding. Traumatic aneurysms are fragile, prone to rupture, and represent a challenging subset of vascular lesions for either surgery or endovascular therapy. Surgical approaches to aneurysms located at the pericallosal arteries are associated with higher rates of morbidity and mortality than approaches to other supratentorial aneurysms. Current endovascular treatment most often involves occlusion of the parent artery with the potential of added morbidity. The authors present their experience in the endovascular management of traumatic and iatrogenic aneurysms of the pericallosal artery achieved by primary coil embolization with parent vessel preservation. For patients harboring traumatic pericallosal aneurysms with favorable anatomical characteristics, in which the morbidity caused by parent vessel occlusion is not acceptable, endosaccular coil placement may be a valuable option.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/16. Distant angiogenesis in a patient with glioblastoma multiforme.The case of a 42-year-old man with a cerebral glioblastoma multiforme associated with marked neovascularization of the arachnoid of the brain stem and spinal cord is reported. All of the neurological symptoms and signs were referrable to the glioblastoma and resultant craniotomies. The arachnoid contained a proliferation of well differentiated blood vessels. This neovascularization occurred in the absence of local tumor or inflammation. We suggest that the neovascularization resulted from release of a tumor angiogenesis factor into the cerebrospinal fluid.- - - - - - - - - - ranking = 12.735064369455keywords = blood vessel, vessel (Clic here for more details about this article) |
8/16. glioblastoma multiforme with extraneural metastases in the absence of previous surgery.A 63-year-old man was found to have an intracerebral glioblastoma multiforme and preoperative roentgenographic evidence of a mass in the middle lobe of the right lung. Because of the rarity of extraneural metastases from glioblastoma, especially in the absence of prior surgery, the lesions were considered to be separate neoplasms until death. The histologic appearance of the lung tumor obtained at autopsy was identical to the cerebral tumor. Additional metastases were found to bronchial lymph nodes and a lumbar vertebra. This case demonstrates that a glioblastoma can spontaneously metastasize extraneurally. Invasion of the glioblastoma into the lumen of a blood vessel was demonstrated within the primary tumor. Embolization of cells to the lung and beyond is the suspected mode of spread.- - - - - - - - - - ranking = 12.735064369455keywords = blood vessel, vessel (Clic here for more details about this article) |
9/16. Pleomorphic xanthoastrocytoma with desmoplastic reaction: angiomatous variant. Report of two cases.Two cases of cerebral pleomorphic xanthoastrocytomas (PXA-s) with prominent vascularity and desmoplastic changes occurring in young subjects are presented. The tumors displayed the marked pleomorphism characteristic of PXA-s and had variable cellularity. The cytoplasm of many tumor cells contained an abundance of lipid droplets. Most tumor cells were positive for glial fibrillary acidic protein. The unusual feature about these tumors was the presence of very large numbers of tiny blood vessels with variable thickness of their walls. In many areas the small vessels and the neoplastic astrocytes were in close proximity to each other, with capillaries adjacent to or protruding into tumor cell cytoplasm, reminiscent of the pattern seen in highly vascularized or "angiomatous" meningiomas. In other areas extensive fibrosis was seen. We feel that the latter, as in the cases of comparably vascular meningiomas, had its origin in congelation and secondary organization of plasma proteins that have exuded through leaky walls of newly formed blood vessels. These are the first reported cases of PXA with an angiogliomatous pattern.- - - - - - - - - - ranking = 26.47012873891keywords = blood vessel, vessel (Clic here for more details about this article) |
10/16. High-grade cerebral neuroblastoma: a case study.The case of a 48-year-old male patient is reported in whom a primary malignant cerebral neoplasm was cured by its neurosurgical removal and by postoperative radiotherapy and chemotherapy. Initially, from the results of the examination of frozen and paraffin section, the tumour was considered to be a glioblastoma multiforme. Electronmicroscopy, immunohistochemistry and review of the light microscopy of the original biopsy sample after his death by suicide four-and-a-half years later showed the neoplasm to have been a primary cerebral neuroblastoma rather than a glioblastoma. The diagnosis of glioblastoma multiforme, which depends upon multiple non-specific microscopic findings, such as necrosis, abnormal blood vessels, anaplasia and the pleomorphism of tumour cells, often is imprecise. Our experience underlines the need for comprehensive neuropathological studies of malignant cerebral neoplasms, including transmission electronmicroscopy and immunohistochemistry. This is of particular importance in view of the dismal prognosis of glioblastoma multiforme and of the palliative, rather than curative, treatment programmes that frequently are indicated for this tumour. The value of our report is to demonstrate that a cerebral neuroblastoma, which potentially is curable, may be mistaken easily for a glioblastoma-even by competent neuropathologists.- - - - - - - - - - ranking = 12.735064369455keywords = blood vessel, vessel (Clic here for more details about this article) |
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