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Yamada R, Inoue H, Kuroda JI, Furuta T, Moritsubo M, Shinojima N, Mukasa A, Mikami Y. Melanotic pilocytic astrocytoma. Neuropathology 2022; 43:197-199. [PMID: 36161674 DOI: 10.1111/neup.12871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Rin Yamada
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - Hirotaka Inoue
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun-Ichiro Kuroda
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
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Mold MJ, Exley C. Aluminium co-localises with Biondi ring tangles in Parkinson's disease and epilepsy. Sci Rep 2022; 12:1465. [PMID: 35087154 PMCID: PMC8795119 DOI: 10.1038/s41598-022-05627-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/12/2022] [Indexed: 12/20/2022] Open
Abstract
Aluminium is known to accumulate in neuropathological hallmarks. However, such has only tentatively been suggested in Biondi ring tangles. Owing to their intracellular and filamentous structure rich in β-pleated sheets, Biondi ring tangles might attract the adventitious binding of aluminium in regions of the blood-cerebrospinal fluid barrier. The study's objective was to establish whether aluminium co-localises with Biondi ring tangles in the brains of Parkinson's disease donors versus a donor that went on to develop late-onset epilepsy. Herein, we have performed immunohistochemistry for phosphorylated tau, complemented with aluminium-specific fluorescence microscopy in the choroid plexus of Parkinson's disease donors and in a donor that developed late-onset epilepsy. Aluminium co-localises with lipid-rich Biondi ring tangles in the choroid plexus. While Biondi ring tangles are not composed of phosphorylated tau, the latter is identified in nuclei of choroidal cells where aluminium and Biondi ring tangles are co-located. Although Biondi ring tangles are considered artefacts in imaging studies using positron emission tomography, their ability to bind aluminium and then release it upon their subsequent rupture and escape from choroidal cells may allow for a mechanism that may propagate for aluminium toxicity in vivo.
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Affiliation(s)
- Matthew John Mold
- The Birchall Centre, Lennard-Jones Laboratories, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Christopher Exley
- The Birchall Centre, Lennard-Jones Laboratories, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Malhotra A, Rao S, Santhoshkumar R, Muralidharan N, Mitra S, Shetty S. Pigmented Ependymoma of the Fourth Ventricle-A Curious Entity: Report of a Rare Case With Review of Literature. Int J Surg Pathol 2020; 29:80-84. [PMID: 32450730 DOI: 10.1177/1066896920926700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 16-year-old boy presented with a tumor located in fourth ventricle, which showed histological features of an ependymoma replete with perivascular pseudorosettes and true ependymal rosettes. Interestingly, many of the tumor cells exhibited abundant cytoplasm stuffed with a grayish brown pigment. Histochemical stains showed the pigment to be acid fast and periodic acid-Schiff positive and negative for Masson-Fontana melanin stain. Additionally, the pigment displayed brilliant autofluorescence under ultraviolet light of a fluorescent microscope. Ultrastructure examination of the pigment revealed a non-membrane-bound biphasic structure with an electron-dense core and electron-lucent periphery. Only few similar case reports mention such pigmented ependymomas to contain a mixture of neuromelanin and lipofuscin while others mention it to be melanin itself. Our workup suggests the pigment to represent lipofuscin or its derivative. Generally known to be a pigment of wear and tear, the significance of finding it in a tumor with such abundance remains to be understood and explored.
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Affiliation(s)
- Ankit Malhotra
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Shilpa Rao
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | | | - Saikat Mitra
- National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Leber SL, Leber KA, Haybaeck J. Spinal melanotic ependymoma: A case report and review of literature. Pathol Res Pract 2019; 215:152380. [DOI: 10.1016/j.prp.2019.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/03/2019] [Accepted: 03/03/2019] [Indexed: 11/15/2022]
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Kakimoto Y, Okada C, Kawabe N, Sasaki A, Tsukamoto H, Nagao R, Osawa M. Myocardial lipofuscin accumulation in ageing and sudden cardiac death. Sci Rep 2019; 9:3304. [PMID: 30824797 PMCID: PMC6397159 DOI: 10.1038/s41598-019-40250-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/12/2019] [Indexed: 01/10/2023] Open
Abstract
Lipofuscin is an intracellular aggregate of highly oxidized proteins that cannot be digested in the ubiquitin-proteasome system and accumulate mainly in lysosomes, especially in aged cells and pathological conditions. However, no systematic study has evaluated the cardiac accumulation of lipofuscin during human ageing and sudden cardiac death (SCD). Age estimation in unidentified bodies and postmortem SCD diagnosis are important themes in forensics. Thus, we aimed to elucidate their correlations with myocardial lipofuscin accumulation. We collected 76 cardiac samples from autopsy patients aged 20–97 years. After histopathological examination, myocardial lipofuscin was measured using its autofluorescence. Lipofuscin accumulated mainly in the perinuclear zone, and its accumulation rate positively correlated with chronological ageing (r = 0.82). Meanwhile, no significant change in lipofuscin level was observed with different causes of death, including SCD. There was also no significant change in lipofuscin level in relation to body mass index, serum brain natriuretic peptide level, or heart weight. Moreover, we performed LC3 and p62 immunoblotting to evaluate autophagic activity, and no change was observed in ageing. Therefore, lipofuscin accumulation more directly reflects chronological ageing rather than human cardiac pathology. Our study reveals the stability and utility of cardiac lipofuscin measurement for age estimation during autopsy.
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Affiliation(s)
- Yu Kakimoto
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Chisa Okada
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Noboru Kawabe
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Ayumi Sasaki
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Hideo Tsukamoto
- Support Center for Medical Research and Education, Tokai University, Kanagawa, Japan
| | - Ryoko Nagao
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Motoki Osawa
- Department of Forensic Medicine, Tokai University School of Medicine, Kanagawa, Japan
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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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7
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Pigmented ganglioglioma in a patient with chronic epilepsy and cortical dysplasia. J Clin Neurosci 2016; 24:17-21. [DOI: 10.1016/j.jocn.2015.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 08/14/2015] [Indexed: 11/16/2022]
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Jiménez-Heffernan JA, Bárcena C, Agra C, Asunción A. Cytologic features of the normal pineal gland of adults. Diagn Cytopathol 2015; 43:642-5. [PMID: 25914033 DOI: 10.1002/dc.23282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 02/13/2015] [Accepted: 03/30/2015] [Indexed: 11/08/2022]
Abstract
It is well known that the histology of normal pineal gland may resemble not only pineal tumors but also gliomas, owing to its cellularity which is much greater than that of normal white or gray matter. Our recent experience with a case in which part of a normal gland was submitted for intraoperative consultation, together with the scarcity of cytologic descriptions, led us to perform a cyto-histologic correlation study. In addition to the intraoperative case, we collected five pineal glands from consecutive adult autopsies. During the squash procedure, we often noted the presence of calcified grains. Smears were hypercellular, distributed in tissue fibrillary fragments and as numerous single cells, with crystalline structures. Pineal gland cells (pineocytes) were large, round, epithelioid with ill-defined cytoplasms and moderate nuclear pleomorphism. Spindle cells with greater fibrillary quality were less common. One of the most remarkable findings seen in all cases was the presence of cytoplasmic pigment. Histological evaluation and immunohistochemical staining confirmed that the tissue was normal pineal gland. The histology showed a characteristic lobular aspect and frequent corpora arenacea. The pigment seen cytologically was also encountered in histology and corresponded to lipofuscin. Cytologic features of the pineal gland are peculiar when compared to other normal structures of the central nervous system. These features correlate closely with what is seen on histology. In an adequate clinical context, and in combination with frozen sections, cytology allows a specific recognition of the pineal gland during intraoperative pathologic consultations.
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Affiliation(s)
- José A Jiménez-Heffernan
- Department of Pathology, University Hospital La Princesa, Madrid, Spain.,Department of Pathology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Carmen Bárcena
- Department of Pathology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Carolina Agra
- Department of Pathology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Alfonso Asunción
- Department of Pathology, University Hospital La Princesa, Madrid, Spain
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Combined haemosiderin and melanin pigmentation of prominent submucosal plexus ganglia and nerves within a pedunculated sigmoid tubular adenoma. Pathology 2014; 47:80-2. [PMID: 25474522 DOI: 10.1097/pat.0000000000000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Yang C, Li G, Fang J, Wu L, Deng X, Xu Y. Clinical analysis of primary melanotic ependymoma in the central nervous system: case series and literature review. Acta Neurochir (Wien) 2013; 155:1839-47. [PMID: 23873122 DOI: 10.1007/s00701-013-1810-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 06/21/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Melanotic ependymoma (ME) is an extremely rare subset of ependymoma characterized by cytoplasmic and extracellular deposition of melanin, with no case series having been reported to date. The aim of this study was to analyze the clinical manifestations, pathological and radiological features, treatment, and follow-up data, and to discuss the diagnosis, management and prognosis of ME. METHODS We retrospectively reviewed the clinical and imaging data of six patients with primary ME. The diagnosis was based on radiological and pathological criteria. All the patients were treated surgically with gross total resection. The preoperative and postoperative neurological states of the patients were analyzed. All the follow-up data were obtained from office visits, and the long-term outcomes are presented and discussed. RESULTS Patients presented with nonspecific symptoms. On magnetic resonance imaging (MRI), although a characteristic signal variation could be found reflecting the melanin component, individual appearances varied widely and were related to the content and distribution of melanin in the ME lesions. The characteristic ependymoma-related pathological appearance and specific immunostaining for glial fibrillary acidic protein and antimelanoma monoclonal antibody were revealed. During a mean follow-up period of 46.8 months, no local recurrences or distant metastases were observed. CONCLUSIONS The accurate diagnosis of ME depends on pathology. The histological grading used for ependymoma can be applied. Most MEs have a relatively benign course. Complete surgical resection alone is the treatment of choice for low-grade MEs, and the outcome may be favorable. Postoperative adjuvant radiotherapy can be considered for lesions with histologically anaplastic features.
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Affiliation(s)
- Chenlong Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.6, Tiantan Xili, Chongwen District, Beijing, 100050, China,
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Costa S, Marques J, Pereira P, Firmo C, Pimentel J. 23-year-old man with a superficial cortical brain tumor. Brain Pathol 2012; 22:429-32. [PMID: 22497616 DOI: 10.1111/j.1750-3639.2012.00590.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 23-year-old male presented with a tonic-clonic generalized seizure. Neuroradiological examination revealed a superficial cystic mass with a mural nodule in the right fronto-parietal lobe. Histological and immunohistochemical examination were consistent with a pigmented (melanin producing) desmoplastic ganglioglioma.These tumors have been first described in childhood, one of them displaying melanin deposits. Only twenty cases of non-infantile desmoplastic gangliogliomas have been reported in the literature, none of them pigmented. According to the clinical and histomorphology (including the desmoplastic component) features, the differential diagnosis should include the ganglioglioma, the xanthoastrocytoma pleomorphic (both tumors also with pigmented forms) and the superficial desmoplastic infantile astrocytoma.
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Rare histological variants in ependymomas: histopathological analysis of 13 cases. Virchows Arch 2011; 459:423-9. [PMID: 21792667 DOI: 10.1007/s00428-011-1126-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Abstract
Ependymomas are rare brain tumors representing about 3% of all intra-cerebral and spinal neoplasms. The WHO classification recognizes various rare histological ependymoma variants (i.e., lipidized ependymoma, giant cell ependymoma, etc.). However, a detailed analysis of a larger series of such cases is still lacking. We analyzed 13 case of ependymoma presenting unusual histological features. The data analysis of our series and its comparison to the cases published in literature did not reveal any close association between these features and the clinical parameters (such as age or localization). Moreover, some of these features can be found combined in individual tumors, suggesting that these variants may represent a spectrum of differentiation rather than true specific entities. However, awareness on these rare histological patterns in ependymomas is necessary in the differential diagnosis with other primary or secondary brain tumors.
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Xiong J, Chu SG, Mao Y, Wang Y. Pigmented pleomorphic xanthoastrocytoma: a rare variant and literature review. Neuropathology 2011; 31:88-92. [PMID: 20573030 DOI: 10.1111/j.1440-1789.2010.01132.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A 16-year-old male teenager presented with seizure and loss of consciousness for 20 min. Magnetic resonance imaging demonstrated a mass occupying the right medial temporal lobe. Histological examination revealed a non-pigmented area with spindle-shaped and large xanthomatous pleomorphic cells and a pigmented region with pigmented neoplastic cells with fascicular arrangement. Immunohistochemical studies showed the tumor was positive for GFAP and low index of Ki-67. Considering the patient's history, clinical data and pathological findings, we rendered a rare variant named pigmented pleomorphic xanthoastrocytoma.
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Affiliation(s)
- Ji Xiong
- Department of Neuropathology, Institute of Neurology, Huashan Hospital of Fudan University, Shanghai, China
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Abstract
On histopathologic examination, many non-neoplastic conditions mimic benign or malignant neoplasms. Alternatively, some benign and malignant neoplasms can also mimic non-neoplastic lesions. This is true of all organ systemsskin is no exception. Examples of these mimickers can be found in skin lesions of almost all tissue types, including those that are melanocytic, lymphoid, epithelial, neural, vascular, neuroendocrine, and fibrohistiocytic. Melanocytic neoplasms are particularly important as it's challenging to differentiate them as being benign or malignant, and it's difficult to tell them apart from non-melanocytic neoplasms. This review illustrates examples of non-melanocytic lesions that disguise themselves as melanocytic.
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Affiliation(s)
- Jag Bhawan
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA.
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Ertan Y, Sarsık B, Özgiray E, Kitis Ö, Dalbastı T, Akalın T. Pigmented ependymoma with signet-ring cells and Rosenthal fibers: A rare variant of ependymoma. Neuropathology 2010; 30:71-5. [DOI: 10.1111/j.1440-1789.2009.01031.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Glioblastoma with signet-ring morphology: a case report and review of the literature. Hum Pathol 2009; 41:443-6. [PMID: 19954819 DOI: 10.1016/j.humpath.2009.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2009] [Revised: 06/25/2009] [Accepted: 08/21/2009] [Indexed: 11/23/2022]
Abstract
Primary central nervous system tumors with signet-ring morphology are exceedingly rare. We report an unusual case of glioblastoma with signet-ring cell features in an 81-year-old woman. Microscopic examination revealed a highly anaplastic tumor, with a prominent proportion of tumor cells exhibiting signet-ring appearance characterized by classic round cytoplasmic inclusions and eccentrically positioned nuclei. The tumor cells were immunoreactive for glial fibrillary acidic protein and S100, and negative for cytokeratins, confirming their glial origin. Ultrastructurally, the tumor cells were noted to contain intermediate filaments, and by fluorescence in-situ hybridization analysis, they demonstrated intact 1p/19q. The presence of signet-ring cells in the central nervous system should immediately raise the suspicion of metastatic carcinoma, particularly from the upper gastrointestinal tract. In the present case, however, the morphological and immunohistochemical features were diagnostic of a malignant primary glial neoplasm (glioblastoma). This case highlights the diagnostic difficulties that can arise in such instances, given the rarity of signet-ring morphology in primary central nervous system tumors.
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Bal N, Bolat F, Hacivelioglu SO, Kocer NE, Canpolat ET. Pigmented apocrine hydrocystoma with lipofuscin of the vulva: a case report. J Eur Acad Dermatol Venereol 2008; 22:771-2. [DOI: 10.1111/j.1468-3083.2007.02484.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Krossnes BK, Mella O, Wester K, Mørk SJ. Pigmented astrocytoma with suprasellar location: case report and literature review. Acta Neuropathol 2004; 108:461-6. [PMID: 15365722 DOI: 10.1007/s00401-004-0903-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2004] [Revised: 06/14/2004] [Accepted: 06/18/2004] [Indexed: 10/26/2022]
Abstract
A large suprasellar, partly cystic, contrast-enhancing tumor was resected from a 19-year-old woman who presented with bitemporal visual field defects and reduced visual acuity. Grossly, the tumor was brown and located in the subarachnoid space. Histologically, it was composed of spindle and pleomorphic cells, including giant tumor cells, with markedly pleomorphic nuclei. Reticulin fibers surrounded single cells and small groups of cells. Very few mitotic figures were found in the tumor, and no necrosis or microvascular proliferation was seen. The tumor thereby resembled a pleomorphic xanthoastrocytoma. Many of the tumor cells contained a dark-brown intracytoplasmic pigment, shown to be melanosomal melanin by ultrastructural examination. Immunohistochemical examination demonstrated that the pigment was present in glial tumor cells. Only four cases of pigmented astrocytic tumors have been published, none of these were suprasellar. Our patient received fractionated radiotherapy with a total dose of 48.6 Gy 14 months after gross total removal of the tumor. She is alive without relapse after 12-year follow-up.
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Affiliation(s)
- Bård Kronen Krossnes
- The Gade Institute, Department of Pathology, Haukeland University Hospital, 5021 Bergen, Norway.
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