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Jakobiec FA, Zakka FR, Papakostas T, Mukai S. Early Neuroblastic and Astrocytic Differentiation Demonstrated Immunohistochemically in a Small Intraocular Medulloepithelioma. Ocul Oncol Pathol 2018; 4:176-181. [PMID: 29765950 DOI: 10.1159/000481287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/28/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the source of fibrous astrocytes and neuroblasts in a small ciliary body medulloepithelioma appearing as a leukocoria in a 3-week-old baby girl. Methods Histopathologic and immunohistochemical studies included Alcian blue, periodic acid-Schiff, and antisera for the detection of S100 protein, CD99, glial fibrillary acidic protein (GFAP), CRX, NeuN, neurofilaments, synaptophysin, desmin, and myogenin. Results A small, nonteratoid ciliary body medulloepithelioma with collections of Alcian blue+ mucoplysaccharides was present in the enucleated globe. The retinal mass displayed multilaminar dysplastic rosettes that were CRX+, NeuN-, and synaptophysin-. Intraretinal neurofilaments and scattered NeuN+ neurocytes were also identified. At the base of the retinal mass ribbons and pseudopapillae of CRX+, NeuN- medullary epithelium were found. The latter developed from an S100+ and weakly CD99+ monolayer of premedullary epithelium. GFAP+ fibrous astrocytes and NeuN- neuroblasts streamed from the medullary epithelium. Conclusions A multilaminar medullary epithelium and a precursor monolayer of premedullary epithelium were both identified. Neuroblasts and fibrous astrocytes were determined to arise separately from the medullary epithelium. The early stage of tumorigenesis afforded by a small tumor provided the opportunity to discover morphologic and immunohistochemical evidence for these differentiations.
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Affiliation(s)
- Frederick A Jakobiec
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Fouad R Zakka
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Thanos Papakostas
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Shizuo Mukai
- Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Boston, MA, USA.,Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Massachusetts Eye and Ear Infirmary, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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