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A Primary Pigmented Choroid Plexus Papilloma Located Within the Sella Turcica: Case Report and Literature Review. World Neurosurg 2017; 105:1039.e13-1039.e18. [DOI: 10.1016/j.wneu.2017.06.155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 11/21/2022]
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2
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Nuclear CRX and FOXJ1 Expression Differentiates Non-Germ Cell Pineal Region Tumors and Supports the Ependymal Differentiation of Papillary Tumor of the Pineal Region. Am J Surg Pathol 2017; 41:1410-1421. [PMID: 28719464 DOI: 10.1097/pas.0000000000000903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Papillary tumor of the pineal region (PTPR) is a neuroepithelial neoplasm first described in 2003. Despite the anatomic association of PTPR with the pineal gland, the features of these tumors resemble those of the ependymal circumventricular subcommissural organ (SCO) of the posterior third ventricle. Given the presumed distinct derivation of PTPR and pineal parenchymal tumors, we hypothesized that expression of lineage-specific transcription factors could distinguish these tumors and provide additional insight into the differentiation of PTPR. A broad series of pineal region samples was reviewed, including 7 benign pineal glands, 4 pineal cysts, 13 pineocytomas, 28 pineal parenchymal tumors of intermediate differentiation, 11 pineoblastomas, and 18 PTPR. All samples were evaluated by immunohistochemistry for expression of CRX, a master transcriptional regulator of photoreceptor differentiation expressed in pineal gland and retina and/or FOXJ1, a master transcriptional regulator of ciliogenesis expressed in normal ependymal cells and ependymal neoplasms. Diffuse nuclear CRX expression is present in 100% of pineal samples. FOXJ1 is negative in all pineal samples. CRX staining is present in 53% of PTPR, though expression is nearly always limited to rare cells. Diffuse nuclear FOXJ1 expression is present in 100% of PTPR. Fetal human SCO diffusely expressed FOXJ1 but was negative for CRX. Immunohistochemistry for FOXJ1 and CRX differentiates non-germ cell pineal region tumors with high sensitivity and specificity, including pineal parenchymal tumors and PTPR. Our findings support the hypothesis that PTPR have ependymal differentiation and are phenotypically more similar to SCO than pineal gland.
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Current therapy and the evolving molecular landscape of paediatric ependymoma. Eur J Cancer 2017; 70:34-41. [DOI: 10.1016/j.ejca.2016.10.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 09/25/2016] [Accepted: 10/12/2016] [Indexed: 01/13/2023]
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Abstract
Over the past 150 years since Virchow's initial characterization of ependymoma, incredible efforts have been made in the classification of these tumors and in the care of pediatric patients with this disease. While the advent of modern neurosurgery and the optimization of radiation have provided significant gains, a more complex but incomplete picture of pediatric ependymomas has begun to form through a combination of international collaborations and detailed genetic and histologic characterizations. This review includes and synthesizes the clinical understanding of pediatric ependymoma and their developing molecular insight into what is truly a family of malignancies in which distinct members require different surgical approaches, radiation plans, and targeted therapies.
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Affiliation(s)
- Nicholas A Vitanza
- Division of Child Neurology, Department of Neurology, Lucile Packard Children's Hospital at Stanford, Stanford University, Palo Alto, CA, USA
| | - Sonia Partap
- Division of Child Neurology, Department of Neurology, Lucile Packard Children's Hospital at Stanford, Stanford University, Palo Alto, CA, USA
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Lee Y, Kim SI, Kim SK, Kim IO, Park SH. A mixed choroid plexus papilloma and ependymoma. Brain Tumor Pathol 2015; 33:147-50. [PMID: 26670168 DOI: 10.1007/s10014-015-0242-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/21/2015] [Indexed: 11/28/2022]
Abstract
We report a novel case of a mixed choroid plexus papilloma (CPP) and ependymoma with cartilaginous differentiation. This kind of mixed tumor has not been previously reported in the English literature. The patient was a 5-year-old girl, who presented with a 1-week history of fever and numbness of the right lower limb. Magnetic resonance imaging of the brain with gadolinium revealed a heterogeneously enhancing mass in the occipital horn of the left lateral ventricle. Histologically, the tumor showed an intermixed CPP area and a low-grade papillary ependymoma-like area, which was studded with cartilage islands and psammoma bodies. In many foci, direct transition of CPP and ependymoma was observed, but there were no high-grade features. We report this novel case, describe the unique microscopic and immunohistochemical features, and speculate on the pathogenesis.
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Affiliation(s)
- Yujin Lee
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea
| | - Seong Ik Kim
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University Children's Hospital and College of Medicine, Seoul, Republic of Korea
| | - In One Kim
- Department of Radiology, Seoul National University Children's Hospital and College of Medicine, Seoul, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. .,Neuroscience Institute, Seoul National University, College of Medicine, Seoul, Republic of Korea.
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Mendes de Cordova F, Vaz Burns L, Tony Ramos A, Estevan Moron S, Silva de Cordova CA, da Luz Silva GM. Cerebral malacia in a mule with ependymoma. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- F. Mendes de Cordova
- Escola de Medicina Veterinária e Zootecnia; Universidade Federal do Tocantins (UFT); Araguaína Brazil
| | - L. Vaz Burns
- Escola de Medicina Veterinária e Zootecnia; Universidade Federal do Tocantins (UFT); Araguaína Brazil
| | - A. Tony Ramos
- Campus Curitibanos; Universidade Federal de Santa Catarina (UFSC); Curitibanos Brazil
| | - S. Estevan Moron
- Unidade CIMBA; Universidade Federal do Tocantins (UFT); Araguaína Brazil
| | - C. A. Silva de Cordova
- Escola de Medicina Veterinária e Zootecnia; Universidade Federal do Tocantins (UFT); Araguaína Brazil
| | - G. M. da Luz Silva
- Escola de Medicina Veterinária e Zootecnia; Universidade Federal do Tocantins (UFT); Araguaína Brazil
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7
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Magrini S, Feletti A, Marton E, Longatti P. Gliomas of the pineal region. J Neurooncol 2013; 115:103-11. [PMID: 23820809 DOI: 10.1007/s11060-013-1200-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
Although several series of pineal region tumors are available, the issue of pineal gliomas has been scarcely faced in the literature. Gliomas are usually included in largest series of pineal neoplasms. Therefore, whether pineal gliomas share the biological behavior of either hemispheric gliomas or other midline lesions is not yet defined. The aim of this retrospective study is to analyze long-term morbidity and mortality of these lesions. In English published literature gliomas account for about 14-22 % of all pineal region tumors. Most of these tumors are pilocytic astrocytomas, while glioblastoma multiforme is rare. We retrospectively analyzed all pineal region tumors operated on in our department in the last 28 years, and identified eight pineal astrocytomas, accounting for 14.03 % of all pineal tumors. The series includes four pilocytic astrocytomas, two grade II diffuse astrocytomas, and two anaplastic astrocytomas. A comprehensive review of the available literature data shows that the mean survival time of WHO grade II gliomas is shorter when tumor grows in the pineal region than for hemispheric locations, although the limited amount of available data prevents a rigorous statistical analysis. This difference might be due to the peculiar infiltrating behavior of pineal tumors, which often can't be satisfactorily resected from vital structures.
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Affiliation(s)
- Salima Magrini
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Piazzale Ospedale 1, 31100, Treviso, Italy
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Bian LG, Sun QF, Wu HC, Jiang H, Sun YH, Shen JK. Primary choroid plexus papilloma in the pituitary fossa: case report and literature review. Acta Neurochir (Wien) 2011; 153:851-7. [PMID: 21140177 DOI: 10.1007/s00701-010-0884-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 11/12/2010] [Indexed: 11/30/2022]
Abstract
Choroid plexus papillomas are rare tumors of the central nervous system and are usually confined to the ventricular system. We illustrated a primary choroid plexus papilloma in the pituitary fossa. A 31-year-old female presented with amenorrhea and intermittent galactorrhoea, with no visual complaints in the last 2 years. Endocrine testing showed no hormone excess or deficiency of the pituitary and target glands, except for a higher prolactin level (56 ng/ml). A sharply circumscribed regular mass in the sellar region occupying the entire sella turcica and extending into the suprasellar cistern was demonstrated on MR imaging with gadolinium diethylenetriamine pentaacetic acid. The patient underwent an endonasal trans-sphenoidal approach. Complete microsurgical excision and complete preservation of the normal pituitary gland was achieved, with normal prolactin level. The histopathology showed that the lesion was a choroid plexus papilloma. Theories of the origin, the differential diagnosis, and treatment of the rare tumor are discussed.
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Affiliation(s)
- Liu-Guan Bian
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, People's Republic of China.
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Bollo RJ, Zagzag D, Samadani U. Synchronous Choroid Plexus Papilloma of the Fourth Ventricle and Ependymoma of the Filum Terminale: Case Report. Neurosurgery 2010; 67:E1454-9; discussion E1459. [DOI: 10.1227/neu.0b013e3181f35144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND AND IMPORTANCE:
We report the first case of synchronous choroid plexus papilloma of the fourth ventricle and myxopapillary ependymoma of the filum terminale. Both are papillary World Health Organization grade I tumors known to disseminate via cerebrospinal fluid pathways.
CLINICAL PRESENTATION:
A 65-year-old man presented with an incidental mass in the fourth ventricle found on a computed tomography scan of the head after a motor vehicle collision and an intradural mass of the filum terminale. The patient underwent resection of the fourth ventricle mass. After pathological diagnosis of a choroid plexus papilloma, the patient underwent resection of the spinal cord tumor.
CONCLUSION:
This case underscores the need for separate pathological diagnosis in a patient with an intradural spine lesion in the context of a benign intracranial lesion. We detail a panel of immunohistochemical markers essential for distinguishing the 2 papillary neuroectodermal tumors recovered in this case.
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Affiliation(s)
- Robert J Bollo
- Department of Neurosurgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York
| | - David Zagzag
- Departments of Pathology and Neurosurgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York
| | - Uzma Samadani
- Department of Neurosurgery, New York University School of Medicine, NYU Langone Medical Center; and Department of Neurosurgery, New York Harbor Healthcare System, Manhattan Veterans Hospital, New York, New York
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Fèvre-Montange M, Vasiljevic A, Champier J, Jouvet A. Histopathology of tumors of the pineal region. Future Oncol 2010; 6:791-809. [PMID: 20465391 DOI: 10.2217/fon.10.28] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pineal region tumors are heterogeneous lesions and include mainly pineal parenchymal tumors (PPTs), papillary tumors of the pineal region (PTPRs) and germ cell tumors (GCTs). This article describes the cystic pineal gland compared with normal tissue and histopathological features of the most frequent pineal region tumors. PPTs are subdivided into pineocytoma (grade I), pineoblastoma (grade IV) and tumors with intermediate differentiation (PPTIDs; grades II-III). A grading system based on the number of mitoses and neurofilament protein expression distinguishes low- from high-grade PPTID. PTPR is a new tumoral entity thought to originate from the subcommissural organ. GCTs include germinoma, embryonal carcinoma, teratoma, yolk sac tumor and choriocarcinoma and are often of mixed histologic composition. New histogenetic data for GCTs are presented.
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Affiliation(s)
- Michelle Fèvre-Montange
- National Institute of Health & Medical Research (INSERM) U842, University of Lyon, Faculty of Medicine, RTH Laennec, Lyon Cedex 08, France.
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Murali R, Scheithauer BW, Chaseling RW, Owler BK, Ng T. Papillary tumour of the pineal region: cytological features and implications for intraoperative diagnosis. Pathology 2010; 42:474-9. [DOI: 10.3109/00313025.2010.494292] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kaloshi G, Rroji A, Lame A, Leka L, Haxhihyseni E, Vreto G, Petrela M. Natural history of papillary tumor of the pineal region: new insights on biological explanation. J Neurooncol 2010; 100:487-8. [PMID: 20454919 DOI: 10.1007/s11060-010-0198-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 04/13/2010] [Indexed: 11/30/2022]
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Dulai MS, Caccamo DV, Briley AL, Edwards MSB, Fisher PG, Lehman NL. Intramedullary papillary ependymoma with choroid plexus differentiation and cerebrospinal fluid dissemination to the brain. J Neurosurg Pediatr 2010; 5:511-7. [PMID: 20433266 DOI: 10.3171/2009.12.peds09130] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This 8-year-old girl presented with a papillary ependymoma in the thoracic spinal cord. Resection was followed by recurrence at the primary site and later in the lumbosacral thecal sac, followed by cerebrospinal fluid dissemination to the brain approximately 5 years after her initial presentation. The tumor showed cytological and immunohistochemical features overlapping those of classic ependymomas and choroid plexus tumors similar to those seen in uncommon supratentorial papillary ependymomas, also known as papillary tumors of the pineal region. The histopathological and clinical courses of this rare spinal papillary ependymoma exhibiting mixed ependymal and choroid plexus-like differentiation are discussed.
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Affiliation(s)
- Mohanpal S Dulai
- Department of Pathology, Stanford University Medical Center, Stanford, California, USA
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Stark AM, Hugo HH, Nabavi A, Mehdorn HM. Papillary Ependymoma WHO Grade II of the Aqueduct Treated by Endoscopic Tumor Resection. Case Rep Med 2009; 2009:434905. [PMID: 19724655 PMCID: PMC2734933 DOI: 10.1155/2009/434905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 06/17/2009] [Indexed: 11/18/2022] Open
Abstract
Papillary ependymoma is a rare tumor that may be located along the ventricular walls or within the spinal cord. We report the case of a 54-year-old patient with a papillary ependymoma WHO grade II arising at the entrance of the aqueduct. The tumor caused hydrocephalus. The tumor was completely removed via a right-sided endoscopic approach with restoration of the aqueduct. The free cerebrospinal fluid passage through the aqueduct was not only visualized by endoscopy but also controlled by intraoperative high-field magnetic resonance imaging. Therefore, an additional endoscopic third ventriculostomy was unneccessary.
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Affiliation(s)
- Andreas M. Stark
- Klinik für Neurochirurgie, Im Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Heinz-Herrmann Hugo
- Klinik für Neurochirurgie, Im Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Arya Nabavi
- Klinik für Neurochirurgie, Im Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - H. Maximilian Mehdorn
- Klinik für Neurochirurgie, Im Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
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Buffenoir K, Rigoard P, Wager M, Ferrand S, Coulon A, Blanc JL, Bataille B, Listrat A. Papillary tumor of the pineal region in a child: case report and review of the literature. Childs Nerv Syst 2008; 24:379-84. [PMID: 17960392 DOI: 10.1007/s00381-007-0500-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Indexed: 11/29/2022]
Abstract
CASE REPORT A 13-year-old boy presented with a history of intracranial hypertension. Radiologic studies revealed triventricular hydrocephalus secondary to a space-occupying lesion in the pineal region. Endoscopic third ventriculostomy was performed to treat hydrocephalus, and the lesion was biopsied. Complete resection of the tumor was subsequently performed. After a period of uncertainty, the diagnosis of papillary tumor of the pineal region was established. Tumor bed radiotherapy at a dose of 50 Gy was associated. With a follow-up of 15 months, the postoperative course was satisfactory with return to school and no residual tumor on magnetic resonance imaging. CONCLUSION Papillary tumors of the pineal region constitute a rare entity, with a difficult diagnosis, an uncertain prognosis, and a high risk of local recurrence; they must be treated by a combination of surgery and radiotherapy. The only identified prognostic factor is the complete or incomplete nature of surgical resection.
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Affiliation(s)
- Kévin Buffenoir
- Service de Neurochirurgie, CHU de Poitiers, Poitiers, France.
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Dagnew E, Langford LA, Lang FF, DeMonte F. Papillary Tumors of the Pineal Region: Case Report. Neurosurgery 2007; 60:E953-5; discussion E953-5. [PMID: 17460510 DOI: 10.1227/01.neu.0000255443.44365.77] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
The pineal region is a rare intracranial site for metastasis. We report three patients initially considered to have metastatic papillary adenocarcinoma to the pineal region. On review, these papillary, keratin-positive neoplasms meet the criteria for papillary tumor of the pineal region (PTPR).
CLINICAL PRESENTATION
These neoplasms occurred in three women (age range, 37–55 yr). Imaging studies demonstrated well-circumscribed lesions in the pineal region. All patients presented with obstructive hydrocephalus and symptoms attributable to hydrocephalus and tectal compression.
INTERVENTION
All three patients underwent near total microsurgical resection of the pineal region neoplasm, followed by adjuvant radiotherapy. The two patients with long-term follow-up (56–60 mo) have remained clinically stable without evidence of local or distant recurrence. The first two patients were initially diagnosed as having papillary metastatic carcinoma of unknown origin. The third patient was treated after the recent description of PTPR and met the histopathological diagnostic criteria. Retrospective pathological review of the previous two patients resulted in designation as PTPR.
CONCLUSION
The morphological features of the tumors in our series, along with the clinical presentations, are similar to those in the original description of the PTPR. Our findings agree with the original hypothesis that the cells composing the PTPR are similar to ependymal cells of the subcommissural organ, thus furthering the hypothesis that the PTPR derives from a specialized ependymocyte associated with the subcommissural organ. The two patients with long-term follow-up (56–60 mo) have remained clinically stable without evidence of local or distant recurrence.
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KAWAHARA I, TOKUNAGA Y, YAGI N, ISEKI M, ABE K, HAYASHI T. Papillary Tumor of the Pineal Region -Case Report-. Neurol Med Chir (Tokyo) 2007; 47:568-71. [DOI: 10.2176/nmc.47.568] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ichiro KAWAHARA
- Department of Neurosurgery, Nagasaki Prefectural Shimabara Hospital
| | | | - Nobuhiro YAGI
- Department of Neurosurgery, Nagasaki Prefectural Shimabara Hospital
| | | | - Kuniko ABE
- Department of Clinical Pathology, Nagasaki University Hospital
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Fèvre-Montange M, Hasselblatt M, Figarella-Branger D, Chauveinc L, Champier J, Saint-Pierre G, Taillandier L, Coulon A, Paulus W, Fauchon F, Jouvet A. Prognosis and Histopathologic Features in Papillary Tumors of the Pineal Region. J Neuropathol Exp Neurol 2006; 65:1004-11. [PMID: 17021405 DOI: 10.1097/01.jnen.0000240462.80263.13] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Papillary tumor of the pineal region (PTPR) is a recently described tumor entity thought to arise from the specialized ependyma of the subcommissural organ. Whereas histologic features of PTPR are well defined, data on the prognostic value of PTPR remain scarce. We therefore investigated clinicopathologic features, including data on progression-free survival and overall survival, in a retrospective series of 31 PTPR. The age of the 14 males and 17 females ranged from 5 to 66 years (median age, 29 years). Histologically, all tumors were characterized by an epithelial-like growth pattern in which the vessels were covered by layers of columnar or cuboidal tumor cells forming perivascular pseudorosettes. Most of the tumor cells showed strong expression of neuron-specific enolase, cytokeratins (particularly CK18), S-100 protein, and vimentin. Most PTPRs examined also expressed microtubule-associated protein-2. Expression of synaptophysin, epithelial membrane antigen, transthyretin, neural cell adhesion molecule, and nestin was encountered in some tumors. Gross total resection could be achieved in 21 of 31 cases; 15 patients received radiotherapy on resection of the primary tumor. Nevertheless, the majority of patients experienced recurrences; 5-year estimates for overall survival and progression-free survival were 73% and 27%, respectively. To conclude, the clinical course of PTPR is characterized by frequent local recurrence, and the value of radiotherapy on disease progression will need to be investigated in future prospective trials.
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Hasselblatt M, Blümcke I, Jeibmann A, Rickert CH, Jouvet A, van de Nes JAP, Kuchelmeister K, Brunn A, Fevre-Montange M, Paulus W. Immunohistochemical profile and chromosomal imbalances in papillary tumours of the pineal region. Neuropathol Appl Neurobiol 2006; 32:278-83. [PMID: 16640646 DOI: 10.1111/j.1365-2990.2006.00723.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The histopathology of papillary tumours of the pineal region (PTPR) closely resembles that of ependymomas and choroid plexus tumours. Therefore, immunohistochemical staining profiles were investigated in a series of 15 PTPR. In addition to cytokeratin, synaptophysin and glial fibrillary acidic protein expression, PTPR were examined for the presence of dot- or ring-like epithelial membrane antigen (EMA) immunoreactivity typically encountered in ependymoma, staining for inwardly rectifying potassium channel Kir7.1 and stanniocalcin-1 (specifically expressed in choroid plexus tumours) as well as microtubule-associated protein-2 (MAP-2). Furthermore, comparative genomic hybridization was performed in five PTPR. Cytokeratin was expressed in all PTPR examined, whereas glial fibrillary acidic protein and synaptophysin staining were absent. Dot- or ring-like EMA immunoreactivity was only observed in 1 out of 15 PTPR. Membranous Kir7.1 and cytoplasmic stanniocalcin-1 staining were present in the minority of PTPR (3/15 and 4/15, respectively). In contrast, MAP-2 immunoreactivity was encountered in 13 out of 15 PTPR, but was significantly less frequently observed in a series of choroid plexus tumours (7/37). PTPR mainly presented with chromosomal losses affecting chromosomes 10 (4/5 cases) and 22q (3/5 cases) as well as gains on chromosomes 4 (4/5 cases), 8 (3/5 cases), 9 (3/5 cases) and 12 (3/5 cases). To conclude, the majority of PTPR can be distinguished from ependymomas and choroid plexus tumours by absent staining for epithelial membrane antigen, Kir7.1 and staniocalcin-1 as well as the presence of distinct MAP-2 immunoreactivity. Antibodies directed against these antigens are thus expected to be valuable markers in the diagnosis of papillary tumours located in the vicinity of the third ventricle.
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Affiliation(s)
- M Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany.
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20
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Kang KS, Yokozawa T, Kim HY, Park JH. Study on the nitric oxide scavenging effects of ginseng and its compounds. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2006; 54:2558-62. [PMID: 16569043 DOI: 10.1021/jf0529520] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
In this study, an in vitro nitric oxide (*NO)-generating system was used to investigate the *NO-scavenging effects of methanolic extracts of white ginseng (Panax ginseng C.A. Meyer), red ginseng, and sun ginseng and several ginsenosides and phenolic compounds. Sun ginseng extract showed the strongest activity among the three ginseng extracts. None of the ginsenosides used in this experiment showed *NO-scavenging activity, but the phenolic compounds, such as p-coumaric and vanillic acids, and maltol inhibited *NO production in a concentration-dependent manner. Moreover, maltol levels markedly increased by heat processing. Therefore, the enhanced *NO-scavenging activity of ginseng by heat processing was closely related to phenolic acids and the increased content of maltol.
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Affiliation(s)
- Ki Sung Kang
- Institute of Natural Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan
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Kuchelmeister K, Hügens-Penzel M, Jödicke A, Schachenmayr W. Papillary tumour of the pineal region: histodiagnostic considerations. Neuropathol Appl Neurobiol 2006; 32:203-8. [PMID: 16599948 DOI: 10.1111/j.1365-2990.2006.00741.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shibahara J, Todo T, Morita A, Mori H, Aoki S, Fukayama M. Papillary neuroepithelial tumor of the pineal region. A case report. Acta Neuropathol 2004; 108:337-40. [PMID: 15221340 DOI: 10.1007/s00401-004-0898-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2004] [Revised: 06/04/2004] [Accepted: 06/04/2004] [Indexed: 11/30/2022]
Abstract
We present here an unusual case of papillary neuroepithelial tumor of the pineal region. The patient was a 29-year-old female who presented with headaches. A computed tomography scan revealed a tumorous lesion at the pineal region and hydrocephalus. The resected tumor was composed of columnar and cuboidal cells showing characteristics of papillary growth. The tumor cells exhibited diffuse and intense immunoreactivity to cytokeratins and neural cell adhesion molecule. The tumor expressed abundant levels of transthyretin (prealbumin) and appeared ependymal in nature, with numerous microlumens delineated by punctate and ring-like patterns in epithelial membrane antigen staining. Reactivity to synaptophysin and glial fibrillary acidic protein was observed only in the infiltrated non-neoplastic pineal parenchyma. These histological characteristics matched the description of the recently reported papillary tumor of the pineal region thought to originate from the specialized ependyma of the subcommissural organ (SCO). Transthyretin expression of the present case further supports the likelihood of SCO origin, as transthyretin is one of the proteins presumed to be secreted by human SCO.
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Affiliation(s)
- Junji Shibahara
- Department of Pathology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan.
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Abstract
Tumors that primarily or exclusively involve the ventricular system constitute a rare and heterogeneous group. Certain histologic tumor types predominantly occur in children, whereas others are more common in adults. Tumor location provides additional clues to correct diagnosis. When used in conjunction with clinical and radiologic data, histopathologic features can distinguish among this wide range of possibilities to provide the correct diagnosis for optimal patient management.
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Affiliation(s)
- James S Waldron
- Department of Neurological Surgery, University of California at San Francisco, 513 Parnassus, HSW 511, San Francisco, CA 94143-0511, USA
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Jouvet A, Fauchon F, Liberski P, Saint-Pierre G, Didier-Bazes M, Heitzmann A, Delisle MB, Biassette HA, Vincent S, Mikol J, Streichenberger N, Ahboucha S, Brisson C, Belin MF, Fèvre-Montange M. Papillary tumor of the pineal region. Am J Surg Pathol 2003; 27:505-12. [PMID: 12657936 DOI: 10.1097/00000478-200304000-00011] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary papillary tumors of the central nervous system are rare. We have encountered a series of six papillary tumors of the pineal region with distinctive features that appear to represent a clinicopathologic entity. The tumors occurred in four women and two men, ranging in age from 19 to 53 years. Imaging studies showed a large well-circumscribed mass in the pineal region. The tumors were characterized by an epithelial-like growth pattern, in which the vessels were covered by a layer of tumoral cells. In papillary areas, the neoplastic cells were large, columnar or cuboidal, with a clear cytoplasm. Nuclei, round or infolded, were found generally at the basal pole of tumoral cells. Immunohistochemically, the tumor cells showed strong staining for cytokeratin, S-100 protein, neuron-specific enolase, and vimentin but only weak or no staining for epithelial membrane antigen and glial fibrillary acid protein. Ultrastructural examination of two cases revealed abundant rough endoplasmic reticulum with distended cisternae filled with secretory product, microvilli, and perinuclear intermediate filaments. The morphofunctional features of these papillary tumors of the pineal region, remarkably uniform within this series, are similar to those described for ependymal cells of the subcommissural organ, and the papillary tumors of the pineal region may be derived from these specialized ependymocytes.
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Affiliation(s)
- Anne Jouvet
- Hôpital Neurologique, BP Lyon Montchat, 69394 Lyon Cedex 03, France.
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