19 research outputs found

    Histological spectrum of ependymomas and correlation of p53 and Ki- 67 expression with ependymoma grade and subtype

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    BACKGROUND: Clinical and histological criteria for ependymoma prognosis are well recognized. Recently few studies have been done based on Immunohistochemistry for prognostication of these tumours. In this study we have correlated the histlogical spectrum with immmunoexpression of p53 and Ki67 in these tumors. AIMS: To know the incidence of ependymomas; study their morphological spectrum and to evaluate expression of P53 and Ki 67 in diffferent morphological subtypes. MATERIAL AND METHOD: A retrospective sudy was preformed on 70 ependymomas received in a period between 1994 and 2001. Entire tissue received was processed for routine paraffin embedded H&E stained sections. Immunocytochemistry was performed using antibodies to GFAP, EMA, Pancytokeratin and synaptophysin, to differentiate papillary ependymoma from choroid plexus papilloma; clear cell ependymoma from oligodendroglioma and central neurocytoma; ependymoblastoma from other embryonal tumours. p53 and Ki-67 immunohistochemistry was performed to correlate their expression with various tumour grades and subtypes. RESULTS: There were 3 cases (4.2%) of Grade I ependymoma (2 cases of myxopapillary ependymoma and 1 case of subependymoma); 57 cases (81.5%) of ependymoma grade II (43 of these were of classical variety, 11 of clear cell ependymoma, 2 of papillary and 1 case of cellular ependymoma). There were 9 cases (12.8%) of anaplastic ependymoma (one of these was a clear cell ependymoma and 1 case (1.5%) of ependymoblastoma CONCLUSION: p53 and Ki67 indices can be used in routine diagnostic laboratories to supplement the tumor grade on histology and more studies with follow up should be performed toanalyse the prognsis of different subtypes. The expression of Ki 67 and p53 was significantly higher in anaplastic ependymomas. 4 out of 11 cases of clear cell ependymomas showed higher Ki 67 indices as compared to classical grade II ependymomas, thus further highlighting the importance of differentiating the various subtypes

    Symptomatic bilateral cerebellar mass lesions: an unusual presentation of intracranial xanthogranuloma

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    Xanthogranulomas are a group of benign lesions with an incidence of 1.6-7.0% in various autopsy series. Although the lateral ventricle is the most frequent intracranial site involved, most symptomatic cases occur in the choroid plexus, involving the third ventricle. Multicentric bilateral symptomatic cerebellar xanthogranuloma has not been reported previously. We describe a 35-year-old man who presented with a complaint of vertigo, with nystagmus and left-side cerebellar signs found on clinical examination. Radiological evaluation revealed bilateral cerebellar lesions abutting the cerebellopontine angle cistern. The left-side lesion was excised and diagnosed as xanthogranuloma up on histopathological examination. The right-side lesion was subsequently excised 4 years later when it became symptomatic. The role of histopathology cannot be overemphasized in the diagnosis of this rare lesion and long-term follow-up is advised in cases managed conservatively owing to the propensity of this tumor to grow over time

    Solitary extramedullary plasmacytoma of thoracic epidural space presenting with dorsal compressive myelopathy: A case report and review of literature

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    Plasma Cell neoplasms result from monoclonal proliferation of plasma cells. Solitary extramedullary plasmacytomas (SEMPs) are rare and constitute 5% of all plasma cell disorders. SEMPs most commonly involve upper aerodigestive tract. Isolated spinal epidural space involvement by SEMPs is extremely rare and to best of our knowledge only 7 such cases have been reported previously in available English literature. We hereby present a rare case of thoracic epidural SEMP in a 32-year-old female who presented with thoracic compressive myelopathy and discuss the pertinent literature

    Role of bone marrow derived pluripotent stem cells in peripheral nerve repair in adult rats: A morphometric evaluation

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    Objectives: Semi-quantitative and quantitative assessment of the effect of bone marrow-derived mononuclear cells (BM-MNC) on early and late phase of nerve regeneration in rat sciatic nerve model. Materials and Methods: Sciatic nerve transection and repair was performed in 50 inbred female Wistar albino rats divided equally in two groups. In the test group the gap was filled with BM-MNCs obtained from the two male rats and fibrin sealant, while in the control group only fibrin sealant was used. Sciatic nerve was harvested at 15 days and at 60 days interval. Parameters of regeneration were assessed at anastomosis (G), intermediate distal (C), and distal site (A). Semi-quantitative (histopathological) and quantitative (morphometric) parameters were analyzed. Results: At 15 days there was a statistically significant difference found in mean axon diameter, mean nerve thickness and myelin thickness at the repair site (P < 0.05). However, in the distal areas, the axons were sparse and myelin rings were very thin in both the groups. At 60 days, the difference in above-mentioned parameters was statistically significant at the distal most sites. FISH assay confirmed the presence of Y chromosome, confirming the presence of BM-MNCs from the male rats. Conclusions: Transplanting BM-MNC S at the site of peripheral nerve injury leads to significantly better recovery. These differences were evident at the repair site and at the intermediate distal site at 15 days and at the distal most sites at 60 days. With practically no ethical issue regarding their isolation and application, they can be easily used for clinical trials

    Predictive factors for early symptomatic recurrence in pilocytic astrocytoma: does angiogenesis have a role to play?

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    We studied predictive factors with respect to angiogenesis and proliferative indices for early symptomatic recurrences in patients with pilocytic astrocytoma (PA). One hundred and eighteen patients who underwent surgery for PA were divided into non-recurrent and early symptomatic recurrence groups to analyze clinicoradiological and immunohistopathological (n=33) parameters. Patients with non-recurrent tumors presented with synptoms for a mean duration of 10.2 ± 9.1 months while those with recurrent tumors presented slightly earlier (6.9 ± 4.5 months). Common tumor locations were the cerebellum (38.1%), optic chiasm (27.9%), supratentorial region (19.4%) and brainstem (9.3%). Recurrent tumors were mostly located in the cerebellum (44%) and brainstem (33%). Strong contrast enhancement was noted in 70 (59.3%) tumors, while 48 (40.7%) showed poor contrast. Resection was complete in 53% of patients while near total excision was achieved for the remaining patients. Cellularity and plemorphism were similar in both groups. Extensive endothelial proliferation was observed in 18.1% of patients while the remainder showed a focal pattern. Diffuse vascular endothelial growth factor (VEGF) expression was observed in 36.3% of patients while 63.6% showed mild-to-moderate focal expression. Endothelial proliferation and VEGF expression were more pronounced in patients with non-recurrent tumors, but this was not statistically significant. MIB-I labeling indices were similar (1-5%) for both groups. Symptomatic recurrences were common in infratentorial PAs. Radiology, histopathology and proliferative indices did not offer any prognostic information. Angiogenesis markers such as endothelial proliferation and VEFG expression did not predict early symptomatic recurrence. Diffuse VEGF expression and endothelial proliferation were observed in tumors that showed strong contrast enhancement

    Pineal anlage tumour - a rare entity with divergent histology

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    Pineal anlage tumour is a rare tumour of the pineal gland that is not listed in the 2007 World Health Organization classification of tumours of the central nervous system. Pineal anlage has been defined as a primary pineal tumour with both neuroepithelial and ectomesenchymal differentiation but without endodermal differentiation. We report a pineal anlage tumour in a 4-month-old boy, the youngest patient reported with this rare tumour, with a brief review of the literature. Clinicians and neuropathologists should be aware of this entity as it is likely to be misdiagnosed as a teratoma or a melanocytic tumour of the central nervous system

    Medulloblastomas: a correlative study of MIB-1 proliferation index along with expression of c-Myc, ERBB2, and anti-apoptotic proteins along with histological typing and clinical outcome

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    Background: Medulloblastoma (MB) is the most common pediatric brain tumor. It is however rare in adults. The genetic and protein expression profile of medulloblastoma is complex, which is worthwhile in terms of prognostication and development or selection of targeted therapy. Aims and objectives: The aims and objectives to correlate the MIB-1 proliferation index and protein expression profiles of c-Myc, ERBB2, and anti-apoptotic proteins (Bcl2 and Bcl-xL) in tumor cells with histological subtypes and clinical outcome. Methods and material: In 50 cases, histopathological subtyping was done, and protein expression profiling by immunohistochemical technique was performed by stains for MIB-1, Bcl2, Bcl-xL, c-Myc, and ERBB2 in 30 cases. The findings were correlated with histological types and patient's average follow-up data. Results: Histological subtypes were similar to that described in literatures. The average expression of Bcl2, Bcl-xL, MIB-1, c-Myc, and ERBB2 were as follows: 50.38%, 38.18%, 59.03%, 46.16%, and 59.62%, respectively. Bcl2 expression showed statistically significant correlation with progress-free survival (PFS) [p=0.046], while ERBB2 and MIB-1 showed a trend of higher expression in progressive disease. The protein expression pattern did not correlate with histological subtypes. Conclusion: Though Bcl-2, ERBB2, and MIB-1 LI came out to be potential markers of aggressive behavior, c-Myc did not correlate with PFS in MB

    A clinicopathological and molecular analysis of glioblastoma multiforme with long-term survival

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    The median survival time of patients with glioblastoma multiforme (GBM) is 12 months, and only 3-5% of patients survive longer than 3 years. We performed histomorphological and detailed molecular analyses of seven long-term survivors of GBM to identify any prognostic factors that potentially contribute to survival. Morphology and immunohistochemistry for p53, phosphatase and tensin homologue (PTEN) and epidermal growth factor receptor (EGFR) protein expression were investigated. EGFR amplification and 1p/19q deletion were assessed by fluorescent in situ hybridization. The O6-methylguanine-DNA methyltransferase (MGMT) gene methylation status was evaluated by performing methylation-specific polymerase chain reaction assays. All tumors were classical GBMs and no significant oligodendroglial differentiation was noted. The majority showed EGFR amplification (4/7), PTEN protein expression (6/7) and MGMT promoter methylation (5/6). Immunopositivity for p53 was noted in three of seven patients. Deletion of chromosome 1p/19q, either isolated or combined, was not identified in any of the se patients. All patients were treated by gross total resection followed by radiotherapy; six patients received additional temozolomide treatment. A relatively young age of onset (48 years), with a high MGMT promoter methylation and PTEN protein expression were favorable factors for long-term survival. The presence of EGFR amplification indicates that more than a single factor determines survival in GBM
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