Biomedical subjects
Publications and source records attributed to S Coca.
A case of multiple schwannomas arising from the falx in a 17-year-old girl, previously operated on for an intracerebral schwannoma, is presented. The appearance of multiple schwannomas has to be considered in the followup of the rare cases of intracranial schwannomas not related to cranial nerves.
A case of follicular lymphomatoid papulosis was studied by light- and electron-microscopic methods. The nature of atypical cells was analyzed with monoclonal antibodies. This case proved to be mainly a type B lymphomatoid papulosis with a predominance of T-helper markers in atypical lymphoid cells. All previously reported cases of this rare variant corresponded to type A lymphomatoid papulosis. Therefore we believe this to be the first case report of type B follicular lymphomatoid papulosis.
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Seven glioblastomas were studied between 1 and 6 months after intratumoral injection of autologous lymphocytes and human lymphoblastoid interferon. Morphological study showed a great number of lymphocytes within the tumor tissue, and interactions between lymphocytes and glioblastoma cells, suggesting a killing phenomenon. These data support the potential usefulness of adoptive immunotherapy in patients with glioblastoma by means of intratumoral administration of activated lymphoid cells.
A monoclonal antibody against the surface marker IOT-10 of natural killer (NK) cells was used to investigate the presence and distribution of these cells in a series of nine primary intracranial germinomas. In all of these tumors, IOT-10-positive NK cells were found in small numbers, mainly distributed among the tumor cells. The data obtained in the present study suggest that the presence of NK cells in primary intracranial germinomas can be influenced by factors other than the mere quantity of tumor-infiltrating lymphocytes.
A case of papillary pineocytoma is presented. It is necessary to be aware of this unusual histological type of pineocytoma in order to make a differential diagnosis among other types of papillary tumors that arise in the pineal region.
A case of secondary cerebral angiosarcoma in a 30-year-old man is presented. The patient had previously undergone heart transplantation for treatment of the primary tumor. Only a few cases of cerebral metastasis from angiosarcoma have been recorded in the literature; the present case is the first reported case diagnosed after heart transplantation.
The clinicopathological experience associated with five cases of pineocytoma is presented. All patients were treated by surgical removal without postoperative radiotherapy. In three individuals, 2000 cGy was administered to the tumor as a presurgical diagnostic test, with no evidence of response. All cases demonstrated histological features of pineocytoma, according to the criteria of Borit et al., and of the so-called "pineocytoma with neuronal differentiation," according to the criteria of Rubinstein. The experience obtained from the present series reveals that these tumors can occur in the initial decades of life, that a cystic appearance and the presence of calcifications are distinctive features of their radiological evaluation, and that they have a good prognosis after surgical removal, even when the histological data indicate local invasion. The convenience of reserving the term "pineocytoma" for these tumors, and of including the so-called "pineocytomas without further differentiation" within the group of pineoblastomas, is suggested in order to achieve a practical clinicopathological assessment of parenchymatous pineal tumors.
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Preliminary experience with a clinical trial of immunotherapy for glioblastoma, by means of intratumoural injection of autologous lymphocytes (AL) mixed with low doses of human lymphoblastoid interferon (HLI) is presented. In two of twelve patients, a transient reduction of tumoural volume was obtained. Morphological studies showed that injected lymphocytes remain within the tumour, and suggest tumoural lysis due to activity of natural killer (NK) cells. Clinically no significant prolongation of survival time could be achieved and, as in other series, patients with additional radiation therapy survived longer. But the morphological findings suggest that immunotherapy carrying NK-cells to contact with tumoural cells might be useful in some patients with glioblastoma. Actually no explanation can be given why only two of our cases responded positively. Regarding the otherwise poor prognosis it seems justified to continue these studies.
A monoclonal antibody against the surface marker IOT-10 of natural killer (NK) cells was used to investigate the presence of these cells in a series of 25 glioblastomas. In 40% of the tumors, IOT-10-positive NK cells were found in small numbers scattered among the tumor cells. The presence of IOT-10-positive NK cells was not related to the degree of lymphocytic infiltration in the tumor as demonstrated by hematoxylin and eosin staining, nor did it appear to influence the survival time of the patients studied.
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In part I of this report, the CSF circulatory dynamics of autologous leucocytes labelled with indium-111 and injected in the subarachnoid space, in patients operated on for glioblastoma, were studied. In the Part II, a series of 11 patients with recurrent glioblastoma was studied for evaluating the efficacy of intrathecal injection of autologous leucocytes. Six patients previously had radiotherapy. The results in Part I show that after intrathecal injection of autologous leucocytes, these cells follow throughout the subarachnoid space and pass to the systemic blood circulation, showing no evidence of colonization of the tumour or deposit in the tumoural region. The mean survival of the patients studied in Part II was 8 months. Those six patients who received radiotherapy had a mean survival of 11.4 months, and those five who received only intrathecal injection of autologous leucocytes after surgery, had a mean survival of 4 months. This results seem to demonstrate that immunotherapy, as used in this study, is ineffective in patients with glioblastoma.
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The vomeronasal complex of the rat was studied by means of different staining techniques and light microscopy between the 13th day of gestation and 42 days of postnatal life. The anlage of the vomeronasal organ in the 13-day-old embryo consisted of a cluster of cells proliferating from the olfactory placode towards the medial line. The vomeronasal organ was well developed by the end of gestation, showing the same ratio between receptor and receptor-free epithelium as in the adult animal. However, full development of the epithelia did not occur until the end of the second postnatal week. Glandular rudiments were observed within the vomeronasal area in 17-day-old fetuses, but the gland showed no sign of activity until the 7th day of postnatal life, when a slight PAS-positive reaction was observed in their cells' cytoplasm. This PAS-positive reaction intensified considerably during the second week and corresponded to the adult picture by the end of this time. The content of the vomeronasal glands contrasted with that of the glands flowing into the nasal fossa, which did not show any PAS-positive reaction but which stained positive for alcian blue. We also studied the evolution of the blood vessels such as the capsule of the complex. This capsule showed complete ossification by the beginning of the 3rd postnatal week, with the exception of certain regions which remained cartilaginous in the adult. Some capillaries were observed in the complex in 17-day-old fetuses, and by 20 days of gestation some of them could be observed penetrating the receptor epithelium. Subsequently, the vascularization of the complex became so profuse that one could consider the vomeronasal complex to consist of erectile tissue.
The immunoreactivity of a panel of poly- and monoclonal antibodies raised against different neuronal and glial antigens, was studied in paraffin-embedded specimens of five pineocytomas. Antibodies against neuron-specific enolase (NSE), S-100 protein, neurofilaments protein (NFP), glial fibrillar acidic protein (GFAP), myelin basic protein (MBP), Synaptophysin (SYN) and vimentin were used. NSE immunoreactivity was detectable in nearly all tumoral cells. S-100 expression was present in all tumors, but a significant variation in the number of S-100 positive cells was noted in the different specimens; they ranged from 3% of S-100 positive cells in some areas of case 1, to 30% in other areas of case 4. The number of GFAP-positive cells detected in four of the five tumors was minimal. In the remaining tumor, 10% to 14% the positively GFAP antisera-stained cells could be seen in some areas; this tumor was considered a pineocytoma with astrocytic differentiation. MBP immunoreactivity was found in isolated cells only in one tumor. Neurofilaments or vimentin expression could not be found in tumoral cells. Synaptophysin was studied in two tumors (cases 4 and 5). Both tumors showed a fine granular neuropil pattern of immunoreactivity, but only in isolated cells of case 5, occasional cytoplasmic positivity could be determined. Based upon our results we can conclude that NSE and synaptophysin are markers that may be applied in the diagnosis of pineocytomas. Further, our results support the hypothesis that the tumoral cells in these neoplasms are of neuroendocrine origin.
Intraventricular neurocytoma is a rare clinicopathological entity that has been recently described. We are reporting our experience with four diagnosed cases and the previously reported cases from the available literature are reviewed. These neoplasms occur mainly in young adults, and their histological diagnosis is difficult on light microscope, because they are almost indistinguishable from oligodendrogliomas. Nevertheless, the presence of tumoral cells arranged around nucleus-free fibrillary zones, resembling the large rosettes of pineocytomas and the immunohistochemical demonstration of synaptophysin are useful data for the pathological diagnosis. This diagnosis is easy on electron microscope, because it demonstrates the neuronal nature of tumoral cells. Regarding prognosis, we have found increasing evidence that these tumors are associated with a favourable course after surgery, and at present there is no clear evidence of the usefulness of radiotherapy.