Dysembryoplastic disorders in neoplastic and non-neoplastic process associated with temporal lobe epilepsy.
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Adolescent↗
Biomedical subjects
H Kroh
Publications and source records attributed to H Kroh.
[The value of structural neuroimaging in the selection of patients for epileptic surgery].
UNLABELLED: The aim of this study was to investigate the value of structural neuroimaging with MRI in the selection of patients for epilepsy surgery. We sought to determine whether MRI influenced decision concerning resective surgery and whether MRI provided much more useful information than enhanced CT. MATERIALS AND METHODS: Neuroimaging studies, MRI and CT, of 300 patients; 265 with partial and 35 with primary generalized seizures, evaluated for surgical treatment of epilepsy were analysed. The MRIs and CTs were interpreted using visual diagnostic criteria and findings were correlated with the EEG changes and clinical semiology. RESULTS: MRIs identified structural lesions in 142, CTs in 96 of all patients. The clinical semiology (partial seizures), MRI, CT and EEG focal findings were concordant in 72 cases. The group of 34 patients had resective surgery. The 7 patients were also operated with MRI and CT focal abnormalities discordant with EEG changes. Also one patient with primary generalized epilepsy and temporal lobe lesion (glioma) had resective surgery. MRI studies revealed structural lesions in 48 patients with normal CT studies. The 43 patients with partial epilepsy had normal CTs and lesions in MRIs; the 34 cases revealed correlation with the EEG findings in 29 temporal and 5 extratemporal regions. Surgery were performed in 23 cases. Also one with partial seizures and MRI detected hippocampal atrophy was operated, despite of generalized EEG patterns. In contrast CT revealed two patients with normal MRI and focal changes. The patients with partial seizures and only CT abnormalities (focal calcifications) were not operated due to discordant EEG findings. In group of 132 patients with normal neuroimaging studies and EEG identified seizure focus only 27 had anterior temporal lobectomy. CONCLUSION: MRI studies gave additional information in case of 16% patients with intractable epilepsy in comparison with CT findings. Resective epilepsy surgery was almost twice as often performed when MRIs revealed structural abnormality. In operated patients, diagnostic sensitivity of structural MRI, CT and EEG to neurophatology were 70.6%, 46.7 and 92.4% respectively.
Adolescent↗
Lectin histochemistry of ethylnitrosourea-induced oligodendrogliomas in the rat.
Oligodendrogliomas (n = 26) induced by ethylnitrosourea (ENU) in wistar rats were examined to assess the lectin specificity to oligodendroglial membranes. Two different types of oligodendrogliomas were found in our material: an isomorphous type (n = 12), and a polymorphous type (n = 14). The first one, with two variants according to its size, macro- (n = 9) and microtumors (n = 3), had predominantly a honey-comb pattern with 'clear halos' around the nuclei without anaplasia. The second type, composed mostly by macrotumours, was anaplastic, with high cellular density, necrosis and intratumoral hemorrhages. Peanut agglutinin (PNA) labelled plasma membranes of well-differentiated cellular components of the first group. The tumoral oligodendrocytes lost the property to bind PNA in the second group of tumours, while Concanavalin A (Con A) showed affinity to intracytoplasmic structures of these tumours. PNA is a reliable marker of oligodendroglial plasma membrane of well-differentiated ENU-induced oligodendrogliomas. This experimental model, using PNA and Con A, may have important clinical applications regarding the biological behaviour of this type of neoplasm.
Animals↗
Intracranial hemangiopericytomas. Histological and immunohistochemical study.
The authors report on 8 cases of intracranial supratentorial tumors which clinically corresponded to meningeal neoplasms. Only one patient revealed the recurrence. The age of patients was 39-74, prevailed women (5). Histological features of tumors, except some variations in two cases agreed with common morphologic pattern of hemangiopericytomas. Immunohistochemical study with following antibodies was performed: vimentin, epithelial membrane antigen, cytokeratin, S-100 protein, fibronectin, desmin, collagen IV, factor RAg, and glial fibrillary acidic protein. Two atypical cases which presented scarce pseudocalcifications and tendency to concentric cellular structures did not differ from other hemangiopericytomas by their intrinsic immunohistochemical properties such as negative reaction to epithelial membrane antigen and cytokeratin. Atypical positive immunostaining with S-100 protein and with glial fibrillary acidic protein was found solely in the group or perivascular cells in one of those atypical cases reflecting probably local astrocytes embedded in tumor tissue. Immunohistochemical investigations did not present univocal data to explain controversial origin of hemangiopericytomas either from meningeal cup cells or from vascular pericytes.
Adult↗
Subependymal giant cell astrocytoma: clinical, histologic and immunohistochemical characteristic of 3 cases.
Three cases of subependymal giant cell astrocytoma (SEGA) in the women aged 23, 26, and 36 years were reported. Two of them had no clinical evidence of tuberous sclerosis complex (TSC) and the one woman presented apparent mental retardation. All patients manifested sudden clinical onset with symptoms of elevated intracranial pressure due to tumor of lateral ventricles and obstructive hydrocephalus. At surgery, the neoplasm was removed totally in one case and resected partially in 2 cases. Histologically, the tumors were composed of large polygonal cells with vesicular nuclei, prominent nucleoli and glassy eosinophilic cytoplasm, intermingled with spindle and small cells. In addition, multinucleated and bizarre giant cells were present, but they were very numerous in one case only. The tumor cells revealed in all cases variegated immunoreactivity for glial fibrillary acidic protein (GFAP), S-100 protein, vimentin (VIM) and neuron-specific enolase (NSE), with stronger expression of VIM than GFAP in 2 cases. Immunostaining of neurofilament proteins and synaptophysin was negative. The results suggest rather astroglial incomplete or aberrant differentiation and maturation than neuronal differentiation of tumor cells. The immunohistochemical variations of SEGA in asymptomatic TSC cases and those associated with tuberous sclerosis are discussed.
Adult↗
Cerebral gangliogliomas. Morphological and immunohistochemical study.
Report concerns 6 uncommon cases of cerebral ganglioglioma in adult patients, the majority of whom (4) demonstrated typical classic features, others were anaplastic. Both types presented neuronal and glial components characterized either by NF, NSE and Syn or GFAP immunoreactivity. Only the tumor of the youngest patient presented moderate desmoplasia. Observations indicate at an easy classification of glial component contrary to neuronal component in relation to the origin of neuronal changes.
Adolescent↗
Choroid plexus carcinoma. Case report.
Report concerns the uncommon cerebellar neoplasm of choroid plexus in 57-year-old woman, which was devoid of some anaplastic features causing doubts about degree of tumor differentiation. Immuno- and histochemical study presented positive CK, VIM, GFAP, S-100 immunostaining and positive PAS-dimedone reaction conforming histological diagnosis.
Carcinoma↗
Meningiomas and gliomas in juxtaposition: casual or causal coexistence? Report of two cases.
Two cases of meningioma and glioma established in biopsy material from one or more than one operation are reported. In these cases, an originally benign meningioma was followed by the development of anaplastic astrocytoma in close juxtaposition to the site of first operation. The close juxtaposition of two histologically different tumors suggested that one of them might lead to local proliferation and independent growth of the other.
Brain Neoplasms↗
Multiple cerebral cavernous angiomas. Case report.
This 26-year-old woman was admitted to Neurosurgery Department in 1972 for the first time due to increased intracranial pressure and since observed and treated by ventriculo-peritoneal shunt during next twenty years. First symptoms such as visual disturbances, hemiparesis and hemianesthesia appeared 8 years earlier followed 4 years later by epileptic fits. Ventriculography revealed hydrocephalus and the tumor in the region of the third ventricle. CT scan visualized multiple hyperdense foci. Ventriculo-peritoneal shunt provided good improvement. During the next twenty years condition of the patient gradually worsened. Diagnosis of multiple cavernous angiomas was established only at autopsy.
Adult↗
Concanavalin A binding by the hippocampal neurons following brief cerebral ischemia in gerbils.
Twenty two Mongolian gerbils after 5 min bilateral carotid artery occlusion and 6, 12, 24, 48, 72, 94 hours and 5 days survival were investigated for the neuronal changes in dorsal hippocampus. Paraffin sections were stained with cresyl-violet and marked by their binding of Concanavalin A (Con A) labelled with peroxidase. The degeneration and neuronal loss was observed only in CA1 sectors in almost all experimental groups, whereas the decreased binding of Con A by the neurons of CA1 sector corresponded to the intensity of histologic changes but appeared also only in this sector even without any histological changes. These observation can point at the subthreshold damage of CA1 neurons as result of either diminished supply or increased metabolism of d-glucose, or diminished number of Con A receptors or changes of their specificity after ischemic period.
Animals↗
Intracranial meningiomas following irradiation therapy for brain tumors.
Two cases of radiation-induced meningiomas following therapeutic irradiation given for primary diagnosed malignant brain tumor are presented. The meningiomas, histologically different from the initial brain tumor, appeared 15 and 21 years after high-dose brain irradiation. The possible risk of carcinogenesis within the CNS resulted from therapeutic cranial irradiation is stressed.
Brain↗
Immunoreactivity of astroglia after brief ischemia resulting in asymmetrical damage to the hippocampal CA1 sector in the Mongolian gerbil.
The study was performed on 98 Mongolian gerbils. Cerebral ischemia was evoked by ligation of both common carotid arteries for 5 min. After five postischemic days the animals were decapitated, brains fixed, paraffin section stained with histological methods and for GFAP with ABC method. The investigated animals (ca 18%) presented asymmetrical morphological lesions of the CA1 hippocampal sector showing irregular loss of neurons in both cerebral hemispheres. GFAP immunostaining demonstrated various astroglial proliferation in asymmetrical lesions of CA1 sector. In partial injury to CA1 neurons the astrocytes in stratum (s) pyramidale were single but their number still increased when total loss of pyramidal neurons occurred. Except s. lacunosum moleculare the number of GFAP-positive astrocytes in the remaining layers of dorsal hippocampus presented a direct relationship with the intensity of morphological changes and was highest when 70% loss of pyramidal cells was observed.
Animals↗
Supratentorial astrocytoma associated with arteriovenous malformation. Case report.
A case of the 18-year-old boy suffering from epilepsy since 8 years and suspected of microangioma is presented. The craniotomy revealed left parietal parasagittal superficially located neoplasm and arteriovenous malformation beneath. Unexpected fibrillary astrocytoma associated with vascular tumor was the diagnostic problem, solved histologically after the operation. The problem of coexistence of various neoplasms with arteriovenous malformations is discussed.
Adolescent↗
Glial differentiation in medulloblastoma. Case report.
A 30-year-old man suffered for a year of a typical syndrome of cerebellar tumor. At suboccipital craniectomy a soft tumor infiltrating both hemispheres and vermis, filling up part of the IV ventricle was found. After subtotal removal of the neoplasm the postoperative course was poor and the patient died 5 weeks later. Biopsy material consisted of three types of tissue: 1. large nests of carrot-shaped, hyperchromatic cells, 2. fields of "halo" cells presenting myelin basic protein (MBP) immunoreactivity and 3. fields and scattered strongly GFAP-positive cells. The histological and immunocytochemical pattern of the neoplasm indicates differentiation of the tumor into oligodendrogliomatous and astrocytomatous line being an uncommon example of dual glial differentiation capability in medulloblastoma.
Adult↗
Neuropathological changes in resected temporal lobe of patients with cryptogenic epilepsy.
The study was performed on cerebral tissue resected during temporal lobectomy in 16 patients whose long-standing cryptogenic epilepsy did not submit to anticonvulsive drugs. Cases presenting definite etiological factors such as CNS trauma, infection or neoplasm were excluded. Neuropathological investigations disclosed microangiomas and focal vascular malformations in the meninges and tissue in 7 patients. Neuronal heterotopias in the white matter and of the white matter in the cortex were observed in 3 cases. Main cortical changes were: neuronal loss, chronic neuronal degeneration, perineuronal satellitosis, and GFAP-positive submeningeal gliosis, especially at the bottom of sulci, perivascular gliosis and laminar or diffuse gliosis. The changes in the hippocampus were most enhanced in the end-plate and in the sector H3 of the pyramidal layer. Astrocytic gliosis in the white matter presented distinct GFAP and S-100 immunostaining; the latter involved in some cases a wider area than the GFAP reaction. The above named changes are analysed with regard to the presumed epileptogenic factors and to the postepileptic damage.
Adolescent↗
Immunoreactivity of astroglia in the hippocampus of the Mongolian gerbil during short survival following brief ischemia.
Mongolian gerbils subjected to 5-min cerebral ischemia by common carotid artery ligation were decapitated after 24, 48, 72 and 96 h of survival to investigate the immunoreactivity of astroglia in the hippocampus. The sections from formalin-fixed, paraffin-embedded brains were stained histologically and with ABC method (Hsu et al. 1981). Control animals (normal and shame-operated) presented positive GFAP immunostaining in corpus callosum, in subventricular regions, in temporal subcortical white matter, in fimbria hipocampi and perivascularly in stratum lacunosum-moleculare. Experimental animals, independently of postischemic survival time showed various individual GFAP reactivity. Differences concerning the number and localization of immunoreactive astrocytes in both cerebral hemispheres of the same animal stressed the asymmetry of the reaction. The authors did not observe any accumulation of reactive astrocytes in the area of synaptic terminals of glutaminergic fibers (mossy fibers, Schaffer's collaterals) or in the neighbourhood of CA1 and CA3 sectors. In particular, there was complete lack or only sporadic reactive astrocytes among pyramidal neurons of CA1 and among granular cells of dentate gyrus in all examined animals.
Animals↗
Anaplastic temporal lobe ganglioglioma. Case report.
Clinical, histological and histochemical features of anaplastic temporal ganglioglioma in a 30-year-old woman are described. Short clinical course (preoperative 2 years, postoperative 6 months), anaplastic features of glial astrocytic component with scarce GFAP and negative vimentin immunostaining indicate aggressive character of the tumor. Ganglionic component is confirmed by the strong Con A affinity and discrete FN and NSE immunostaining.
Adult↗
Experimental CNS tumors in rats. Testing field for a computerized classification and tumor grading.
The purpose of this study was to verify the efficiency of a previously described method for the computerized histological diagnosis of experimental brain tumors (Kroh et al. 1988). 117 tumors (astrocytomas, glioblastomas, meningosarcomas, neurinomas, oligoastrocytomas and oligodendrogliomas), experimentally induced in rats, were studied. In every case the same 50 histological characteristics used for the elaboration of a computerized system for the diagnosis of experimental brain tumors in mice were analyzed. Our results demonstrate the efficiency of this diagnostic method for experimental brain tumors. Furthermore, the grade of malignancy of these tumors was also determined by using a previously described computer program.
Animals↗