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ABSTRACT: A study was undertaken to investigate the correlation between histological invasiveness and proliferating potential and clinical recurrence in meningioma. In 39 meningiomas, the histological findings at the tumour-brain interface zone were classified into 3 types, consisting of 29 cases of non-invasion (NON). 7 cases of nodular invasion (NOD), and 3 cases of intermingled invasion (INT). Proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizer region (AgNOR) indices were studied. PCNA indices (mean +/- standard error) of NON, NOD. and INT were 1.7 +/- 0.1%, 5.2 +/- 0.5%, and 7.5 +/- 0.7%. respectively, and the AgNOR indices (dot number/nucleus) were 1.50 +/- 0.03, 2.00 +/- 0.04, and 2.22 +/- 0.07, respectively. Significant differences were found among the three types in both parameters. Clinically, tumour recurrence was observed in 1/29 NON, 4/7 NOD, and 2/2 INT cases, indicating a higher incidence of recurrence in invasive meningiomas (NOD plus INT). Four of 32 patients who underwent gross total removal of the tumours showed recurrence, and all of these four tumours were invasive meningiomas. The results of the present study showed that tumour invasiveness as measured by PCNA + AgNOR indices correlated well with high proliferative potential and clinical recurrence.
Acta Neurochirurgica 02/1995; 136(3-4):127-31. · 1.52 Impact Factor
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ABSTRACT: We report here a case with meningioma showing malignant transformation in its course of multiple recurrences. A 59-year-old woman developed a right-sided hemiparesis in June, 1982 and CT scan disclosed a parasagittal well-enhanced mass. The tumor was subtotally removed (Simpson grade III) by an operation in September, 1982. Histological findings of the tumor were consistent with a meningothelial meningioma but showed no malignant features, such as high cellularity, necrotic foci, high mitotic rate, or nuclear pleomorphism. However, the tumor did invade the underlying cerebral cortex. In August, 1986, a recurrent tumor was detected by CT scan and was removed (Simpson grade III). The tumor tissue at the second operation showed the same histological features as the first specimen. In September, 1990, the patient developed multiple intracranial recurrences. There were three tumor nodules, all of which were removed. Histologically, significant histological differences between the second and the third operative specimens were found. In the last tumor tissue, one nodule showed a papillary pattern. In the other tumor nodules, each tumor cell had proliferated separately instead of adhering to other tumor cells to form a syncytium. This histological pattern was consistent with an epithelial meningioma described by Cushing and Eisenhardt in 1938. The papillary portion of the tumor was stained with monoclonal antibody Ki-67 in frozen section. The labelling index was 9.7%, which was as high as malignant meningioma. Electron microscopic examination of the papillary portion of the tumor showed that the tumor cells had irregular nuclei, interdigitations between the adjacent plasma membranes and a few ill-developed desmosomes.(ABSTRACT TRUNCATED AT 250 WORDS)
No shinkei geka. Neurological surgery 04/1994; 22(3):285-9. · 0.13 Impact Factor
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ABSTRACT: We conducted a study to investigate whether an association exists among histologic findings, labeling index determined by the labeling index (LI) of proliferating cell nuclear antigen (PCNA) and recurrence in a population of 30 meningioma patients. All of 6 patients (invasive meningioma) with brain invasion had a PCNA LI in excess of 5%. Recurrence was found in 4 of these patients. In 24 patients who did not have brain invasion, PCNA LI was 4% or less and only 1 case had recurrence. Recurrence occurred in 3 of 25 patients who underwent macroscopic total resection and all of these 3 cases had brain invasion and a PCNA LI in excess of 5%. The findings of this study indicated the existence of a close correlation between peripheral invasiveness of meningioma and its biological behavior.
Nōshuyō byōri = Brain tumor pathology 02/1993; 10(1):63-7.
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ABSTRACT: To investigate the possibility that the two subtypes of craniopharyngioma, adamantinous type and squamous papillary type, are tumors arising from different origins, the authors conducted an electron microscopic study in 10 cases of craniopharyngioma. Light microscopic study revealed distinct differences between the two subtypes, but their ultrastructure was fundamentally similar. In this report, the authors propose an explanation of the origin of these subtypes to account for the findings.
Nōshuyō byōri = Brain tumor pathology 02/1993; 10(2):117-23.
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ABSTRACT: Tumor tissue located in the occipital lobe with hemorrhage was obtained from a 19-year-old patient. Histological examination indicated it to consist of undifferentiated small, round cells without neuronal or glial differentiation, and possibly to be a type of primitive neuroectodermal tumor. The tumor cells were cultured for 3 years and a continuous cell line (KK-2) was established. KK-2 was transplantable to nude mice. With immunocytochemistry, neuron-specific enolase, protein gene product 9.5, vimentin, TUJ1 (a monoclonal antibody specific for neuron-associated class III beta-tubulin isotype) and 6H7 (a monoclonal antibody to NCAM produced by us) were detected. None of the following could be found: glial fibrillary acidic protein, S-100 protein, neurofilament and synaptophysin, calcitonin gene-related peptide, gastrin releasing peptide corticotropin-releasing factor, substance P, somatostatin, chromogranin, aromatic L-amino acid decarboxylase and tyrosine hydroxylase. The original tumor and KK-2 cells obtained after 3 years of culture and transplants in nude mice displayed essentially the same ultrastructural and immunohistochemical characteristics. KK-2 cells showed no differentiation to mature neuronal, glial or ependymal cells. This cell line may possibly serve as a useful model for studying cellular differentiation of human neuroectodermal tumors and normal neuronal development.
Acta Neuropathologica 02/1992; 84(1):52-8. · 9.32 Impact Factor
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ABSTRACT: A brain tumor in the fourth ventricle of a 26-year-old woman displayed numerous Homer Wright rosettes by conventional histology, but immunostaining and electron microscopy revealed the tumor an ependymoma. Since the presence of Homer Wright rosettes in ependymoma has not been well appreciated in the past, the diagnostic importance of this finding is discussed.
Journal of Neuro-Oncology 01/1992; 11(3):269-73. · 3.21 Impact Factor
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ABSTRACT: Three cases of meningiomas which had abundant small vacuoles in the tumor tissue are reported. By electron microscopy, the tumor cells exhibited long and thin processes, the tips of which were united by desmosomes. The tumor tissue was revealed to have wide extracellular spaces which corresponded to the vacuoles observed by light microscopy. In previous literature, various terms have been used when referring to this meningioma, such as microcystic meningioma or vacuolated meningioma. Since the ultrastructure of the tumor showed similarity to that of normal arachnoid trabecular cells, we propose to call the tumor "arachnoid trabecular cell meningioma" denoting its morphological nature clearly.
Acta Neuropathologica 02/1991; 82(5):327-30. · 9.32 Impact Factor
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ABSTRACT: The clinical study was undertaken on 24 poor risk patients out of 69 cases with hemorrhagic cerebral arteriovenous malformations, AVMs, and the surgical problems of poor risk patients with the lesions were discussed. The 24 cases, 35%, out of 69 hemorrhagic AVMs cases showed disturbances of consciousness of 3 digits (100-300) according to the Japan Coma Scale at the time of admission. All cases of these poor risk patients were observed less than 24 hours after the onset of the symptoms. Fifteen of these 24 cases showed brainstem signs including anisocoria and/or decerebrate rigidity and/or respiratory arrest. Eighty-three per cent of 24 poor risk patients had serious neurological defects as a result of the first hemorrhage. Therefore, it was impossible to prevent serious state from occurring in poor risk patients. Of the 69 cases with hemorrhagic AVMs, 56 cases were operated upon. Although 90% out of 38 good risk patients whose level of consciousness was 0 to 30 according to the Japan Coma Scale showed good recovery, only 44% of 18 poor risk patients recovered well. It could not be said that the surgical treatment gave satisfactory results for the poor risk patients when compared with the surgical results of the good risk patients. In respect to the location of AVMs, all three poor risk patients with AVMs in the corpus callosum and the ventricles showed good recovery, whereas of the poor risk patients with AVMs in the cerebrum or the cerebellum, only 4 out of 9 cases (44%) and 1 out of 6 cases (17%) showed good recovery respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
No shinkei geka. Neurological surgery 06/1988; 16(6):733-40. · 0.13 Impact Factor
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ABSTRACT: It is difficult to diagnose angiographically occult vascular malformations. When conventional CT (plain & contrast enhancement) can not demonstrate the lesions, it was impossible to diagnose in the past. We developed a new technique which enabled us to diagnose them. Materials and methods; Seven cases of spontaneous intracerebral hemorrhage, in which no abnormality was detected by repeated magnified serial angiography with subtraction technique and prolonged injection technique, were examined. In each case, conventional CT (plain & enhancement using 100 ml of 60% meglumine iothalamate) was performed first, which was immediately followed by the administration of 220 ml of 30% meglumine iothalamate for one hour. CT is taken at the end of the infusion. It, we call, is prolonged high dose delayed contrast CT: PHDD-CT. Total dose of iodine used in this technique was 59.22 gI (1.0 gI/kg body weight: BW). Results; Contrast enhancement effect of PHDD-CT was much better than that of conventional CT in all the cases. In three cases, the lesions were more clearly delineated in PHDD-CT. In four cases, only PHDD-CT could demonstrate the lesions. No side effect was observed. Comments; Several techniques for better enhancement have been reported, however they used large volume of contrast medium such as 1.5 or 2.0 gI/kg BW. Our technique can be performed with more security. Based on our good results, we recommend to use this PHDD-CT technique for the diagnosis of angiographically occult vascular malformations.
No shinkei geka. Neurological surgery 08/1985; 13(8):867-73. · 0.13 Impact Factor
