Biomedical subjects
Publications and source records attributed to D Gambarelli.
A 38 year-old woman treated for breast cancer had 10 months later a cerebral tumor diagnosed as a frontal metastasis. Neurosurgical operation showed a meningioma and a malignant glioma. Although exceptional, such an association, is probably not due to chance.
The authors report a case of a solitary melanotic neurofibroma involving the temporomalar area in a 17-year-old man. Light-microscopic study reveals a benign neurofibroma including melanin deposits. Electron microscopy shows typical premelanosomes and melanosomes within Schwann cell cytoplasm. The literature is reviewed, and theories of histogenesis for this unusual tumor are discussed.
Autopsy specimens from six patients with clinically diagnosed herpes simplex virus (HSV) encephalitis were studied. Since immunocytochemistry has been reported to be a more reliable and successful method to identify HSV as the etiologic agent, antitype 1 HSV (HSV1) and antitype 2 HSV (HSV2) and the avidin-biotin-peroxidase complex (ABC) method were applied to brain paraffin sections. Positive immunostaining was observed in front-orbital, mediobasal temporal lobes, cingulate gyrus, and insula. The staining was bilateral but predominant on one side. In neurons, the cytoplasmic staining was prominent in perikarya and processes, less often observed in nuclei, rarely seen in nuclear inclusions. The positive staining was intense in oligodendrocytes and macrophages, in both nuclei and cytoplasm. In two cases astrocytic processes were stained strongly. Perivascular lymphocytes were always negative. Positive reactions were obtained with both anti-HSV1 and anti-HSV2 but weaker with anti-HSV2. This results suggests that, because of its high sensitivity, ABC method permits viral antigen detection not feasible with other methods. However, this method lacks of accuracy for HSV typing mainly because of probable antigens changes resulting from tissue processing.
A register of stillbirths from the Bouches-du-Rhône area in France was settled in 1982 with the double goal to provide epidemiological data on mortinatality and to help organizing a network of post-mortem examination. The results on 409 stillbirths out of 21.292 consecutive births are presented. The protocol for post-mortem examination included photography, radiography, karyotype and autopsy. A definitive conclusion was drawn in 75% of cases. The fetal anomalies recognized were isolated malformations (14,4%), multiple malformations (5,1%), syndromes (3,2%) and chromosomal anomalies (3,9%).
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Paired twisted filaments (PTF) forming helices are described in tumor cells of three human pinealomas. Each filament was 8.11 +/- 1.55 nm wide. The maximal width of the helix was 16.62 +/- 2.62 nm. The periodicity of the constrictions was 26.63 +/- 4.49 nm. These characteristics appeared original, suggesting protein filaments possibly specific of pinealocytes. The similarities and discrepancies between PTF and Alzheimer's paired helical filaments (PHF) are discussed.
A typical case of acquired immune deficiency syndrome (AIDS) has been clinically and morphologically studied. This homosexual man whose past history was significant for i.v. drug abuse and sexually transmitted infection presented several opportunistic infections with a profound impairment of cell-mediated immunity. Autopsy showed an intense lymphoid depletion, CMV-generalized infection, and a primary large cell immunoblastic lymphoma of the brain. The present case is discussed in the light of recent literature.
A case of suprasellar hemangioblastoma attached to the pituitary stalk is reviewed. The patient presented with amenorrhea-galactorrhea and a highly vascularized suprasellar lesion. Though the exact diagnosis was not made before the operation, the authors emphasize the importance of angiography, which had significant features regarding the diagnosis.
The authors comment on the role of electron microscopy in the diagnosis of brain tumors. This kind of morphological investigation is essential for the differential diagnosis of undifferentiated or round cell tumors, especially on small biopsies. In addition, electron microscopy clarifies the nosology of numerous entities, such as germinomas, lymphomas, astrocytic gliomas, neuronal tumors, medulloblastomas and pinealomas. Finally numerous ultrastructural details are provided, widening our knowledge of the complex pattern of brain tumors.
An ultrastructural study of four pinealomas was carried out to precise eventual specific markers. Dark and clear cells joined with zonulae adherents, extensive and pleiomorphous processes, a complex vacuolar system, and characteristic organelles (lysosome-like structures, clear and dense-core vesicles, vesicle-crowned rodlets and related structures, microtubular sheaves and centriolar derivatives, membranous whorls, fibrous bodies, microtubules, heterogeneous cytoplasmic inclusions) offered a typical pattern. No correlation could be made between the histological and ultrastructural features. The authors stress the ultrastructural similarities between the human tumor cells and the mammalian pineal cells. Pinealomas appeared as a morphological entity distinct from neuronal and astrocytic tumors.
In Macaca nemestrina inoculated intracerebrally by a pin-point injection with a strain of kuru Kupenota (2nd passage), the lesions consisted of spongiosis of neuropile with severe astrocytic hyperplasia, located in the grey matter of cerebral hemispheres (cortex, neostriatum). In all cases, the distribution of lesions was asymmetrical, predominating on the side of injection. These results suggest that kuru agent could be replicate around the injection site, but the influence of the host and/or the strain could not be excluded.
Four cases of progressive multifocal leukoencephalopaty are reported, 3 of them with an ultrastructural study and 2 with a C.T. scan study. In 2 cases, there were no other associated pathological condition. In 1 case chronic alcoholism only was present; in the last case a primitive hemochromatosis with a prevailing hepatic dysfunction was evidenced. In 2 of these cases, the initial clinical picture was made of mental disorders while it was made of a progressive left hemiparesis in one case and of a brain stem syndrome in the other case. The results of neuroradiological and isotopical investigations remained negative throughout the evolution in the 4 cases except for some C.T. scan abnormalities. Indeed, in 2 cases the C.T. scan evidenced brain lesions identified as large demyelinated areas. These were low density areas non altered by contrast and unaccompanied by any mass effect. These areas were not seen when the first clinical signs were present and thus, normality of C.T. scan appears not to allow infirmation of the diagnosis of progressive multifocal leukoencephalopathy. In the 4 cases the pathological study showed characteristic lesions of the white matter. Mononucleated cells inflammatory infiltration was observed at the periphery of the demyelinizated regions. This may be related with the primitive aspect of these cases. An ultrastructural study was performed in 3 cases: viral inclusions were present not only in the nucleus of oligodendrocytes but also in their cytoplasm and in some astrocytes.
An unusual cerebral tumor is reported in a ten-month-old boy. The tumor was large (10 cm x 6 cm), firm and included several cysts. Light and electron microscopy showed a striking cellular pleomorphism. Typical neurosecretory ganglion cells were observed, always surrounded by Schwann cells. Amyelinic neurites, clusters of Schwann cells, fibroblasts and numerous foci of GFA positive astrocytes composed the tumor. These features were compared with the rare previous electron microscopic reports of cerebral neuronal tumor of the central nervous system. A dysembryoplastic origin from the neural plate was retained to explain the growth of such a complex tumor.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.