Dysplastic ganglioneurocytoma with increased glucose metabolism: a heterotopia with unique histopathology

A 1 year and 7 month old boy was incidentally found to have an intracranial mass lesion at the frontal base. The mass was 45 x 54 x 47 mm in size, contained a calcification, a few small cysts, and extended downward to the sphenoid sinus and upper pharynx. The signal intensity of the lesion on magnetic resonance imaging was iso-high on T1-weighted images, and slightly high on T2-weighted images, and it did not enhance with gadolinium injection. Although there was no obvious mass effect, 18F-fluorode-oxyglucose positron-emission tomography demonstrated increased uptake, and a surgical resection was performed suspecting a neoplastic lesion. Histologically, the lesion consisted of small to large anomalous neurons and glial cells but lacked normal cortical architecture. Cellularity was high in some portion with MIB-1 labeling index of 2%, but there was no cellular atypia suggestive of neoplasm. Therefore, this lesion was considered to be a dysplasia that does not fit into the previously described entity. We suggest this lesion would be better described as dysplastic ganglioneurocytoma.

Analysis of interleukin-6 gene expression in primary human gliomas, glioblastoma xenografts, and glioblastoma cell lines

Our previous study showed that high-grade astrocytomas often expressed high interleukin (IL)-1beta production. Coexpression of IL-1beta and IL-6 has been found in a number of glioma samples and glioma cell lines. To characterize the expression of IL-6 in the human glioma microenvironment, we investigated surgically excised human gliomas, human glioblastoma xenografts, and human glioblastoma cell lines using the reverse transcriptase-polymerase chain reaction (RT-PCR), immunohistochemistry (IHC), and enzyme-linked immunosorbent assay (ELISA). In the 29 primary gliomas, transcripts of IL-6 were less frequently detectable (55.6%) than those of IL-1beta (72.4%) or those of IL-10, IL-8, or IL-1alpha (>80% each). As for IL-6 gene expression, little or no transcription was observed in low-grade astrocytomas, oligodendroglial tumors, and 1 ependymoma. Strong IL-6 gene expression was found in only 5 of 9 glioblastomas. Immunohistochemically, IL-6 antigen was localized in the tumor cells and macrophages in 4 of 7 glioblastomas. In 3 glioblastomas transplanted into nude mice, both IL-1beta and IL-6 were detected only in 1, but othercytokines (IL-8, IL-10, and IL-1alpha) were detected in all 3 xenografts by RT-PCR. Two cell lines both showed IL-6 expression at the mRNA level, and in a cell line with a high level of IL-6 and IL-1beta transcripts, significant production of IL-6 was observed by IHC and ELISA. We concluded that IL-6 produced in tumor tissue may be involved in tumor progression in some glioblastomas, but not in low-grade astrocytomas and oligodendroglial tumors, and that IL-6 gene expression is closely correlated with IL-1beta expression in biopsy tissue, xenografts, and cultures of human gliomas.

Brain tumour imaging with carbon-11 choline: comparison with FDG PET and gadolinium-enhanced MR imaging

The purpose of this study was to assess the clinical potential of methyl-11C-choline (11C-choline) in the diagnosis of brain tumours. To this end, the results of 11C-choline positron emission tomography (PET) in 22 patients suspected of having brain tumours were compared with the findings of contrast-enhanced magnetic resonance (MR) imaging and fluorine-18 fluorodeoxyglucose PET. A histopathological diagnosis was made for each patient during open surgery. The standardised uptake values of brain tumours and the tumour-to-white matter count (T/W) ratios were determined. The degree of 11C-choline accumulation noted in PET images was compared with the gadolinium-enhanced areas of MR images. The mean T/W ratio of 11C-choline in high-grade gliomas was found to be higher than that in low-grade gliomas. This difference was statistically significant (mean+/-SD: 8.7+/-6.2, n=9 versus 1.5+/-0.7, n=5, P<0.03) when data pertaining to the prominent uptake of 11C-choline in a patient with a pilocytic astrocytoma were excluded. 11C-choline PET failed to detect non-neoplastic lesions in two patients. Areas of 11C-choline accumulation in PET scans were larger than areas enhanced on MR images in five cases involving high-grade gliomas. 11C-choline PET differentiated between low-grade gliomas and high-grade gliomas, but did not differentiate between low-grade gliomas and non-neoplastic lesions. The combination of 11C-choline PET and MR imaging may provide investigators with an accurate means by which to identify high-grade gliomas.

Glia-synapse interaction through Ca2+-permeable AMPA receptors in Bergmann glia

Glial cells express a variety of neurotransmitter receptors. Notably, Bergmann glial cells in the cerebellum have Ca2+-permeable alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-type glutamate receptors (AMPARs) assembled without the GluR2 subunit. To elucidate the role of these Ca2+-permeable AMPARs, we converted them into Ca2+-impermeable receptors by adenoviral-mediated delivery of the GluR2 gene. This conversion retracted the glial processes ensheathing synapses on Purkinje cell dendritic spines and retarded the removal of synaptically released glutamate. Furthermore, it caused multiple innervation of Purkinje cells by the climbing fibers. Thus, the glial Ca2+-permeable AMPARs are indispensable for proper structural and functional relations between Bergmann glia and glutamatergic synapses.

Central neurocytoma with unusually intense FDG uptake: case report

Central neurocytoma is a benign neuronal tumor with a favorable prognosis. This tumor is typically characterized by decreased uptake of 18F-fluorodeoxy glucose (FDG) and any increased uptake of FDG in patients suffering from this tumor would be highly unusual. A case of central neurocytoma with an intense FDG uptake, combined with atypical histopathological features and a high proliferation index is reported in this paper. A 45-year-old male had a two months' history of right hemiweakness. Magnetic resonance (MR) imaging showed a large tumor in the right lateral ventricle. Positron emission tomography (PET) with FDG revealed high glucose metabolism in the tumor. The histological diagnosis was central neurocytoma with atypical features characterized by microvascular proliferation. The MIB-1 labeling index, ordinarily smaller than 2.0%, was 7.0%. Conventional radiotherapy, with a total dose of 50 Gy, was administered after the surgical treatment. The patient returned to his normal daily activities after the cessation of radiation therapy.

Extension of glial processes by activation of Ca2+-permeable AMPA receptor channels

AMPA type-glutamate receptor channels (AMPARs) assembled without the GluR2 (GluR-B) subunit are characterized by high Ca2+ permeability, and are expressed abundantly in cerebellar Bergmann glial cells. Here we show that the morphology of cultured Bergmann glia-like fusiform cells derived from the rat cerebellum was changed by manipulating expression of Ca2+-permeable AMPARs using adenoviral vector-mediated gene transfer. Converting endogenous Ca2+-permeable AMPARs into Ca2+-impermeable channels by viral-mediated transfer of GluR2 gene induced retraction of glial processes. In contrast, overexpression of Ca2+-permeable AMPARs markedly elongated glial processes. The process extension was blocked by 2,3-Dihydroxy-6-nitro-7-sulfamoylbenzo(F)quinoxaline (NBQX), a specific antagonist of AMPAR. These results indicate that glutamate regulates the morphology of glial processes by activating Ca2+-permeable AMPARs.

Expression of type II iodothyronine deiodinase in brain tumors

Type II iodothyronine deiodinase (DII) messenger ribonucleic acid (mRNA) and its activity have been demonstrated in human normal brain. Although DII activity has been demonstrated in brain tumors, expression of DII mRNA has not been studied in these tumors. To investigate the mechanisms involved in the expression of DII activity in brain tumors, we studied DII mRNA and DII activity in astrocytoma (two cases), glioblastoma (three cases), and oligodendroglioma (one case). DII mRNA, the size of which was indistinguishable from that in control cerebral cortical tissue, was demonstrated in all of the brain tumors tested, although the intensity of the hybridization signal showed wide variation among the tumors. DII activity was also detected in all tumors. DII mRNA and DII activity were highest in the tissue from oligodendroglioma. A significantly positive correlation was observed between DII mRNA and DII activity in these tumors (r = 0.94; P < 0.01), suggesting that DII expression in brain tumors is regulated at the pretranslational level. The present results demonstrate, for the first time, that DII mRNA as well as DII activity are expressed in brain tumors, and that DII mRNA is significantly correlated with DII activity in those tissues.

Pulsed field ionization-ZEKE spectroscopy of cresoles and their aqueous complexes: internal rotation of methyl group and intermolecular vibrations

Pulsed field ionization-ZEKE photoelectron spectroscopy and (1 + 1) R2PI spectroscopy have been applied to the cis- and trans-m-cresol.H2O clusters. The internal rotational structure in the S1 state has been re-assigned, and the potential curve has been determined for the cluster. The PFI-ZEKE spectra of the cis- and trans-isomers show low-frequency bands up to 1000 cm-1 above the adiabatic ionization potential IP0. The low-frequency bands are assigned to the internal rotation of the methyl group, the intermolecular stretching and their combination bands in the m-cresol.H2O cluster cation. Level energies and relative transition intensities are reproduced well by a one-dimensional rotor model with a three-fold axis potential. Potential curves for the internal rotation have been determined for both cis- and trans-isomers of m-cresol.H2O cations. The effect of the cluster formation upon the internal methyl rotation, and the interaction between the methyl rotation and the intermolecular vibration are discussed.

Expression of interleukin-1beta mRNA and protein in human gliomas assessed by RT-PCR and immunohistochemistry

To characterize the expression and localization of interleukin (IL)-1beta in human gliomas, both reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry were used on surgically excised human gliomas, human malignant glioma xenografts, and human glioblastoma cell lines. The RT-PCR products for IL-1beta mRNA were quantified by computerized image analysis. IL-1beta mRNA was detectable in 30 out of 35 (86%) surgically resected gliomas. An abundant expression of IL-1beta mRNA was often found in the glioblastomas, anaplastic astrocytomas, and pilocytic astrocytomas, but not in other types of gliomas. Quantitatively, in both the grade 2 astrocytomas and the oligodendrogliomas, the IL-1beta mRNA levels were significantly (p < 0.05) lower than those of the grade 3/4 astrocytomas. Immunohistochemically, IL-1beta was localized in the pleomorphic tumor cells of the astrocytic tumors and in macrophages. In contrast to the astrocytic tumors, low and high grade oligodendrogliomas showed no or little expression of IL-1beta antigen. IL-1beta was present less frequently than IL-1alpha and IL-1 receptor type 1 in 4 malignant gliomas transplanted into nude mice by RT-PCR. All 2 cell lines showed IL-1beta expression at both the mRNA and protein levels. It is concluded that in human gliomas, both high-grade astrocytomas and pilocytic astrocytomas often express high IL-1beta production, and that IL-1beta is mainly localized in astrocytic tumor cells and macrophages.

In vitro neuronal and glial production and differentiation of human central neurocytoma cells

Human central neurocytoma cells were cultured and characterized immunophenotypically and electrophysiologically to clarify their developmental potential. We conducted systematic in vitro studies utilizing fresh tissues from three patients. Initially small homogeneous cell clusters settled down onto the bottom of the culture flasks, and, after 2 weeks from plating, mature neuron-like cells developed from these clusters and expressed neurofilament proteins (NF: specific neuronal markers). On the other hand, approximately 80% of small round cell clusters and flat glial-like cells from which these clusters developed were positively stained for glial fibrillary acidic protein (GFAP: a specific glial marker). Furthermore these neuronal and glial cells showed distinct morphology, and dual-label, indirect immunohistochemistry for GFAP and NF-200 kD disclosed that the two antigens were not found co-localized in the same cells. In single-cell clonal analysis, neuronal, glial, and mixed neuronal and glial clones were generated. Electrophysiologically, the cells of neuronal morphology possessed sodium channels, and also L-type calcium channels in whole-cell voltage clamp. The sodium channels were of a characteristic neuronal phenotype which appears in neurons. These findings suggest that small round human central neurocytoma cells exhibit both neuronal and glial differentiations and have the properties reminiscent of precursor cells derived from subventricular matrix; thus, these cultured cells may be a potential source for investigations of human CNS neuronal and glial development and differentiation.

Clinicohistological study of oligodendroglioma and oligoastrocytoma

The clinical and histological characteristics of oligodendroglioma and oligoastrocytoma were investigated in patients, mainly adults with supratentorial tumors, who were treated with surgery and radiotherapy, and with chemotherapy for recurrent, anaplastic tumors, or both. The median survival time was 13.2 years for oligodendroglioma (four patients), 12.7 years for anaplastic oligodendroglioma (five patients), 13.5 years for oligoastrocytoma (seven patients), and 4.8 years for anaplastic oligoastrocytoma (four patients). Two of three recurrent oligodendrogliomas and two of two recurrent oligoastrocytomas showed malignant transformation. Minigemistocytes were sometimes recognized in recurrent tumors and had a sinister prognosis. Oligodendroglioma and oligoastrocytoma may transform into each other at recurrence.

Central neurocytoma: an immunohistochemical, ultrastructural and cell culture study

To clarify the histogenesis and differentiation potential of central neurocytoma, a pathological investigation of seven tumors from three patients was conducted using immunohistochemistry and ultrastructural analysis in addition to systematic in vitro studies. Six tumors were studied immunohistochemically and five were examined ultrastructurally. All cases that were immunostained were positive for synaptophysin in nuclear-free neuropil islands. In five tumors, a few tumor cells, in addition to reactive astrocytes, were positive for glial fibrillary acidic protein (GFAP). Vimentin staining was also positive in a few tumor cells of five specimens. Neurofilament staining was always negative. All cases for which ultrastructure was examined showed various synaptic abnormalities. Cultured cells were subdivided into three distinct tumor cell types: neuronal cells which stained for neurofilament proteins with neurosecretory granules; small flat undifferentiated cells with a high nuclear-cytoplasmic ratio and scant cytoplasmic organelles; and small round or multipolar astrocytic cells with 10-nm intermediate filaments which stained for GFAP. Our tissue culture studies disclosed that cultured neurocytoma cells form a cellular mosaic similar to subependymal plate layers that are composed of mitotically active cells, neurons and glia.

Small gliomas: metabolism and blood flow

Eight patients with small gliomas (6 low-grade and 2 high-grade) localized in a single gyrus or less than 2 cm diameter were investigated using positron emission tomography and single photon emission computed tomography. All three tumors examined demonstrated hypermetabolism of amino acids. High-grade gliomas demonstrated hypermetabolism of glucose and high blood flow, but normal or low oxygen metabolism. High-grade gliomas also showed accumulation of 201Tl chloride and high or low accumulation of 123I-isopropyl iodoamphetamine. These indications allow preoperative diagnosis of the malignancy of small gliomas, which is important because small gliomas with high-grade malignancy need more extensive removal and adjuvant therapy.

Small gliomas: clinicopathological study

The clinicopathological characteristics of small gliomas were investigated in nine patients with gliomas less than 2 cm in diameter. The tumor histology and proliferative activity were also examined. Three tumors occurred in the white matter and six at the corticomedullary junction. Histological diagnosis, Daumas-Duport's grading, bromodeoxyuridine labeling index, and proliferating cell nuclear antigen counts were well correlated. Most small gliomas were histologically benign, localized, and removable if not in eloquent areas of the brain. However, some cases showed high-grade glioma and invasive character at the early stage, resulting in a poor outcome.

Intermediate filament expression in pituitary adenomas

Seventy-five formalin-fixed and 18 alcohol-fixed pituitary adenomas were studied immunohistochemically using antibodies to keratin, vimentin, neurofilaments (NFs), glial fibrillary acidic protein, desmin, actin, S-100 protein and a variety of pituitary hormones. The pituitary adenoma cells were positive for keratin, vimentin and NFs (68 kDa and 160 kDa) and in a few instances there was co-expression of these three types of intermediate filaments (IMFs). The pattern of keratin-specific staining showed diffuse cytoplasmic or patchy paranuclear reactivity and of NF- or vimentin-specific staining showed fibrillar or patchy paranuclear reactivity. The patchy staining seemed to decorate the fibrous body. There was no correlation between the distribution of IMFs and pituitary hormones in pituitary adenomas except that melanocyte-stimulating-hormone-positive reactivity was limited to the NF-positive adenomas. The pattern of IMF staining did not depend on hormone production in adenomas.

[Problems entailed in the definition and pathology of anaplastic astrocytoma]

Three-tiered system dividing supratentorial astrocytic neoplasms into the astrocytoma, anaplastic (malignant) astrocytoma and the glioblastoma multiforme has been widely used. However, the pathology of anaplastic astrocytoma is defined in different ways according to different classifications. A total of 42 biopsy specimens from 35 cases diagnosed as anaplastic astrocytoma were reviewed pathologically and their features were correlated with a follow-up clinical study to discuss the prognostic usefulness of the subdivision of anaplastic astrocytoma. In WHO classification, anaplastic astrocytoma is defined as "astrocytoma containing areas of anaplasia". Follow-up study of 7 cases with the histology as such revealed that 5 cases had survived more than one year and seven months. The other 28 cases showed a varied histology and were subclassified into an astrocytoma in which moderately anaplastic cells are found throughout the tumor, an astrocytoma formed by anaplastic fusiform cells, an astrocytoma composed of predominantly rounded anaplastic cells, and a pleomorphic astrocytoma with or without intracytoplasmic hyaline inclusions. A follow-up study of cases with these types of astrocytoma disclosed death in 15 cases within one year and 7 months following the first surgery and that three cases displayed typical histological features of glioblastoma at autopsy. It is considered that there would be a considerable overlap between the group of anaplastic astrocytoma and that of glioblastoma, if we use the term "anaplastic astrocytoma" in a broader category.