Touch-print Cytology of Brain Tumors and Its CorreIation with Histological Features

A cytological preparation of neurosurgical biopsy material is one technique by which a rapid and reliable diagnosis can be made. Many specimens unfit for sectioning may be used, and the detailed cytological nature of the tumor can be evaluated, thus providing valuable information in differential diagnosis from other primary tumors or metastatic lesions. Touch-print specimens of 48 cases of eNS tumors collected during the last year from 1991 are reviewed and compared with paraffin sections of the same biopsies. Touch prints were prepared with specimens for frozed section diagnosis, just before they were utilized for frozen sectioning. Smears were stained both with Wright-Giemsa and Papanicolaou methods. Fourty eight cases of brain tumors consisted of 14 pituitary adenomas, 11 meningiomas, 7 oligodendrogliomas, 4 astrocytomas, 3 glioblastoma multiforme, 3 malignant lymphomas, 2 chordomas, 2 neurilemmomas, 1 pineocytoma, and 1 craniopharyngioma. The cytology and histology of pituitary adenoma and meningioma correlated best in this series. The most consistent findings were monotonous eccentric round nuclei and plump polygonal cytoplasm in the pituitary adenomas and meningothelial cell clusters with whorling pattern and psammoma bodies in meningiomas. The main dificulties encountered were differentiation between nonspecific glial hyperplasia and low-grade astrocytoma as well as grading of astrocytoma and oligodendroglioma. The remaining tumors revealed fairly consistent findings to be correlated with biopsy specimens

Malignant Glioma Arising at the Site of an Excised Cerebellar Hemangioblastoma after Irradiation in a von Hippel-Lindau Disease Patient

We describe herein a malignant glioma arising at the site of the resected hemangioblastoma after irradiation in a patient with von Hippel-Lindau disease (VHL). The patient was a 25 year-old male with multiple hemangioblastomas at the cerebellum and spinal cord, multiple pancreatic cysts and a renal cell carcinoma; he was diagnosed as having VHL disease. The largest hemangioblastoma at the right cerebellar hemisphere was completely removed, and he received high-dose irradiation postoperatively. The tumor recurred at the same site 7 years later, which was a malignant glioma with no evidence of hemangioblastoma. The malignant glioma showed molecular genetic profiles of radiation-induced tumors because of its diffuse p53 immunostaining and the loss of p16 immunoreactivity. The genetic study to find the loss of heterozygosity (LOH) of VHL gene revealed that only the cerebellar hemangioblastoma showed allelic losses for the gene. To the best of our knowledge, this report is the first to show a malignant glioma that developed in a patient with VHL disease after radiation therapy at the site of an excised hemangioblastoma. This report also suggests that radiation therapy should be performed very carefully in VHL patients with hemangioblastomas

Primary Intramedullary Neuroblastoma in Adult

Primary neuroblastoma in the central nervous system(CNS) is unusual tumor in adult, and primary intramedullary neuroblastoma is extremely rare. The authors report a case of 36-year-old woman presenting with pain in the right anterior chest wall and weakness of the right lower extremity. An upper thoracic intraspinal mass was revealed on magnetic resonance image. On operation, the demarcation plane of the tumor was good and enabled a total removal of the subpially located intramedullary mass. Histopathological examination revealed neuroblastoma. After surgery with whole spinal irradiation, the patient was followed up for one year. There was no evidence of local recurrence radiologically and clinically. However fifteen months after the surgery, multiple metastases to the breast, lung, Iioer and brain occurred

Altered expressions of Notch-1 signaling proteins and beta-catenin in progression of carcinoma in situ into squamous carcinoma of uterine cervix

Background: Activation of Notch-1 signaling pathway and loss of membranous beta-catenin have been known to play key roles in the progression of uterine cervix cancer and thus this study focused any alteration in the expression patterns for Notch-1, p53, and cyclin D1 as well as beta-catenin in squamous carcinoma in situ (CIS) and invasive squamous carcinomas to investigate their roles in the progression of CIS to squamous carcinomas. Materials and Methods: Three Notch-1 signaling proteins, such as Notch-1, TP53, and cyclin D1, and a component of cell adhesion complex, beta-catenin, were immunohistochemically stained in 112 uterine cervical tumors including 74 CIS and 38 invasive squamous carcinomas (11 microinvasive and 27 invasive carcinomas). Each immunohistochemical result was compared between CIS and squamous carcinoma groups and the difference was statistically analyzed. Results: Notch-1 protein expression was significantly higher in the microinvasive and invasive carcinomas than in CIS lesions (P = 0.001). Cyclin D1 and p53 immunoreactivities tended to be expressed higher in the invasive group than in CIS (P = 0.056 and 0.060). Membranous beta-catenin expression was significantly reduced in squamous carcinomas compared to CIS (P = 0.000). However, both CIS and squamous carcinoma groups revealed no interrelationship among Notch-1 signaling proteins and beta-catenin. Conclusion: Altered expressions of Notch-1 signaling proteins and beta-catenin in the progression of CIS into squamous carcinoma of uterine cervix suggests that Notch-1 signaling pathway and cell adhesiveness might play key roles in the stromal invasion of CIS cells