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ABSTRACT: Efficient endoscopic surgery in cases involving small ventricles is difficult but possible. The authors describe a neuroendoscopic sheath that has been improved to make it suitable for use with a Leksell stereotactic frame, which enabled us to accurately insert a stereotactic needle into the small ventricle and provided an adequate surgical corridor. A biopsy was performed on a 6-year-old girl who had a primary central nervous system lymphoma in the pineal body without hydrocephalus.
Journal of neurological surgery. Part A, Central European neurosurgery. 01/2013;
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Hiroaki Takeuchi,
Tetsuya Hosoda,
Ryuhei Kitai,
Toshiaki Kodera,
Hidetaka Arishima,
Kenzo Tsunetoshi,
Hiroyuki Neishi, Takahiro Yamauchi,
Kazufumi Sato,
Yoshiyuki Imamura,
Hiroshi Itoh,
Toshihiko Kubota,
Ken-ichiro Kikuta
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ABSTRACT: To investigate whether grade II oligodendroglioma was transformed to glioblastoma or not, histopathological evaluation of recurrent oligodendrogliomal tumors (OG) and diffuse astrocytomas (DA) was performed. The OG group was composed of ten patients with OG, including seven oligodendrogliomas and three oligoastrocytomas. The DA group was composed of ten patients with DA, including eight fibrillary astrocytomas and two gemistocytic astrocytomas. The histopathological parameters of glioblastoma including nuclear atypia, multinucleated giant cells, glomeruloid tufts (GT) as a marker of microvascular proliferation, necrosis, and the Ki-67 staining index were investigated. Evaluation of these parameters was scored as follows: 0, none; 1, sporadic; 2, partial; 3, extensive. There were no cases of transformation to glioblastoma in the OG group. There were five cases of transformation to secondary glioblastoma in the DA group. In recurrent tumors, scores of GT and necrosis in the OG group were significantly lower than those in the DA group (p < 0.005). Nuclear atypia and high proliferative activity (Ki-67 index) were identified in recurrent tumors of the OG group. Our study suggested that the extent of GT and necrosis in recurrent OG was less than that in recurrent DA, and transformation to glioblastoma from oligodendroglial tumor was exceptional.
Brain Tumor Pathology 05/2012; 29(3):140-7. · 1.19 Impact Factor
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Hiroaki Takeuchi,
Tetsuya Hosoda,
Ryuhei Kitai,
Toshiaki Kodera,
Hidetaka Arishima,
Kenzo Tsunetoshi,
Hiroyuki Neishi, Takahiro Yamauchi,
Kazufumi Sato,
Yoshiyuki Imamura,
Hiroshi Itoh,
Toshihiko Kubota,
Ken-ichiro Kikuta
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ABSTRACT: There have been some recent reports about glioblastoma with oligodendroglial (OG) components and malignant glioma with primitive neuroectodermal tumor (PNET)-like components. We investigated whether the presence and extent of OG components and PNET-like components influenced the prognosis in patients with glioblastoma. Eighty-six patients with glioblastoma were divided into an OG group (28 %), which revealed areas with a honeycomb appearance, and a non-OG group (72 %) without a honeycomb appearance. Patients with glioblastoma were also divided into a PNET group (27 %), which revealed areas with PNET-like features defined as neoplastic cells with high N/C ratios and hyperchromatic oval-carrot-shaped nuclei, and lacked the typical honeycomb appearance, and a non-PNET group (73 %) without PNET features. There were no significant differences in overall survival among the OG, the non-OG, the PNET, and the non-PNET groups. Two patients who survived longer than 36 months had both OG and PNET components with 1p or 19q loss of heterozygosity. Perinuclear halo, which is a characteristic feature of oligodendrogliomas, is an artifact of tissue fixation. Therefore, we should not readily use the term glioblastoma with OG components. PNET-like components, which are considered rare in malignant gliomas, may be frequently identified in glioblastomas.
Brain Tumor Pathology 04/2012; 29(3):154-9. · 1.19 Impact Factor
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Ryuhei Kitai,
Hirohito Sasaki,
Ken Matsuda,
Kenzo Tsunetoshi, Takahiro Yamauchi,
Hiroyuki Neishi,
Kazuki Matsumura,
Akira Tsunoda,
Hiroaki Takeuchi,
Kazufumi Sato,
Ken-Ichiro Kikuta
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ABSTRACT: The aims of this study were to determine the diagnostic utility of the serum levels of the soluble interleukin 2 receptor (sIL-2R) as a tumor marker of primary central nervous system lymphoma (PCNSL) and to investigate the cellular source of sIL-2R using immunohistochemical staining. The serum sIL-2R levels of 37 samples from suspected PCNSL patients were measured. There were 13 patients with PCNSL and 24 patients with other diseases such as glioma, metastatic tumor, inflammation, or cerebrovascular disease. The serum sIL-2R levels of the PCNSL cases and other brain diseases were 629.5 ± 586.0 U/ml (mean ± SD; range 189-2220 U/ml) and 408.5 ± 250.7 U/ml (160-837 U/ml), respectively. The serum sIL-2R levels of the two groups overlapped, and hence the difference between them was not significant. sIL-2R is the α subunit of IL-2R. It is also known as CD25, and is cleaved from its position in the cell membrane and released into the blood. CD25 expression was immunohistochemically detected in 7 of 11 PCNSL samples. Confocal laser microscopy revealed that CD25 signals were present in atypical cells and mononuclear cells. We concluded that both lymphoma cells and infiltrating T cells express CD25, which is one of the cellular sources of sIL-2R.
Brain Tumor Pathology 03/2012; · 1.19 Impact Factor
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ABSTRACT: We report a vascular leiomyoma of the extracranial scalp with a small deformity on the skull in a child mimicking a dermoid cyst. The tumor was removed surgically, and histologic examination revealed a vascular leiomyoma. A small deformity-like dimple on the skull improved without evidence of recurrence. The early surgical excision yielded good results.
Pediatric Dermatology 02/2012; · 1.07 Impact Factor
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Brain and nerve = Shinkei kenkyū no shinpo 09/2011; 63(9):1014-5.
