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P Hofman

Publications and source records attributed to P Hofman.

At least 37 records · Page 2Linked to original sources

[Primary signet ring cell carcinoma of the eccrine sweat gland in the eyelid. Immunohistochemical and ultrastructural study of a case].

We report a case of a 45-year-old woman who exhibited a primitive eccrine sweat gland carcinoma of the eyelid. Histological study showed cellular proliferation with an Indian file pattern and some signet ring cells with sialomucin secretion. Immunohistochemical study demonstrated these cells to be positive with the anticytokeratin, anti-EMA, anti-HMFG, antiestrogen receptor and antiprogesterone receptor antibodies. Ultrastructural study showed intracytoplasmic vacuoles with numerous microvilli at the apical side. Differential diagnosis with a metastasis from a mammary adenocarcinoma is difficult and a complete staging is necessary to confirm the primitive origin of the tumor. The behavior of this tumor is marked by locoregional recurrence.

Carcinoma, Signet Ring Cell↗

Ikappa b-alpha, the NF-kappa B inhibitory subunit, interacts with ANT, the mitochondrial ATP/ADP translocator.

The transcription factor NF-kappaB regulates a wide set of genes involved in the establishment of many cellular processes that control cell activation, proliferation, and apoptosis. IkappaB inhibitory subunits integrate NF-kappaB activation signals through phosphorylation and ubiquitination of its N-terminal domain. Using the two-hybrid system in yeast, we searched for IkappaB-alpha N-terminal domain interactors and therefore potential NF-kappaB regulators. An interaction of IkappaB-alpha with the mitochondrial ATP/ADP translocator ANT was detected in yeast and confirmed in glutathione S-transferase pull-down assays and co-precipitation experiments in transfected cells. Subcellular cell fractionation, resistance to proteinase K treatment, and electron microscopy experiments demonstrated the presence of IkappaB-alpha and associated p65 NF-kappaB in the mitochondrial intermembrane space. IkappaB-alpha.NF-kappaB appeared to be released from mitochondria upon the induction of apoptosis by engagement of the Fas receptor. These data suggest that the mitochondrial IkappaB-alpha.NF-kappaB pool participates in the regulation of apoptosis.

Apoptosis↗

A FYVE-finger-containing protein, Rabip4, is a Rab4 effector involved in early endosomal traffic.

The small GTPase Rab4 is implicated in endocytosis in all cell types, but also plays a specific role in some regulated processes. To better understand the role of Rab4 in regulation of vesicular trafficking, we searched for an effector(s) that specifically recognizes its GTP-bound form. We cloned a ubiquitous 69-kDa protein, Rabip4, that behaves as a Rab4 effector in the yeast two-hybrid system and in the mammalian cell. Rabip4 contains two coiled-coil domains and a FYVE-finger domain. When expressed in CHO cells, Rabip4 is present in early endosomes, because it is colocated with endogenous Early Endosome Antigen 1, although it is absent from Rab11-positive recycling endosomes and Rab-7 positive late endosomes. The coexpression of Rabip4 with active Rab4, but not with inactive Rab4, leads to an enlargement of early endosomes. It strongly increases the degree of colocalization of markers of sorting (Rab5) and recycling (Rab11) endosomes with Rab4. Furthermore, the expression of Rabip4 leads to the intracellular retention of a recycling molecule, the glucose transporter Glut 1. We propose that Rabip4, an effector of Rab4, controls early endosomal traffic possibly by activating a backward transport step from recycling to sorting endosomes.

Adaptor Proteins, Signal Transducing↗

Endothelial cell hypertrophy induced by vascular endothelial growth factor in the retina: new insights into the pathogenesis of capillary nonperfusion.

OBJECTIVE: To investigate the mechanism leading to capillary nonperfusion of the retina in a monkey model of vascular endothelial growth factor A (VEGF)-induced retinopathy in which capillary closure occurs in a late stage after VEGF treatment. METHODS: Two monkeys received 4 intravitreous injections of 0.5 microg of VEGF in one eye and of phosphate-buffered saline in the other eye and were killed at day 9. After perfusion and enucleation, retinal samples were snap frozen for immunohistochemical analysis with the panendothelial cell marker CD31 or were fixed for morphometric analysis at the light and electron microscopic level. RESULTS: At the light microscopic level, all capillaries in the retina of VEGF-injected eyes displayed hypertrophic walls with narrow lumina. In a quantitative analysis of the deep capillary plexus in the inner nuclear layer, VEGF-injected eyes had a significant 5- to 7-fold decrease in total capillary luminal volume. CD31 staining showed that this decrease was not accompanied by a change in the number of capillaries. Electron microscopy revealed that the luminal volume of individual capillaries of the inner nuclear layer of VEGF-injected eyes was significantly decreased due to a 2-fold hypertrophy of the endothelial cells. CONCLUSIONS: Luminal narrowing caused by endothelial cell hypertrophy occurs in the deep retinal capillary plexus in VEGF-induced retinopathy in monkeys. This suggests a causal role of endothelial cell hypertrophy in the pathogenesis of VEGF-induced retinal capillary closure. A similar mechanism may operate in retinal conditions in humans associated with ischemia and VEGF overexpression. CLINICAL RELEVANCE: Capillary nonperfusion occurs in diabetic retinopathy and other ischemic diseases associated with overexpression of VEGF. In addition, VEGF-induced endothelial cell hypertrophy may be causative for capillary closure in these diseases.

Animals↗

VEGFR-3 in adult angiogenesis.

Vascular endothelial growth factor receptor 3 (VEGFR-3, Flt-4), the receptor for vascular endothelial growth factors (VEGFs) C and D, is expressed on lymphatic endothelium and may play a role in lymphangiogenesis. In embryonic life, VEGFR-3 is essential for blood vessel development. The purpose of this study was to investigate whether VEGFR-3 is also involved in blood vessel angiogenesis in the adult. This was studied in human tissues showing angiogenesis and in a model of VEGF-A-induced iris neovascularization in the monkey eye, by the use of immunohistochemistry at the light and electron microscopic level. VEGFR-3 was expressed on endothelium of proliferating blood vessels in tumours. In granulation tissue, staining was observed in the proliferative superficial zone in plump blood vessel sprouts, in the intermediate zone in blood vessels and long lymphatic sprouts, and in the deeper fibrous zone in large lymphatics, in a pattern demonstrating that lymphangiogenesis follows behind blood vessel angiogenesis in granulation tissue formation. At the ultrastructural level, VEGFR-3 was localized in the cytoplasm and on the cell membrane of endothelial cells of sprouting blood vessels and sprouting lymphatics. In monkey eyes injected with VEGF-A, blood vessel sprouts on the anterior iris surface and pre-existing blood vessels in the iris expressed VEGFR-3. In conclusion, these results support a role for VEGFR-3 and its ligands VEGF-C and/or VEGF-D in cell-to-cell signalling in adult blood vessel angiogenesis. The expression of VEGFR-3 in VEGF-A-induced iris neovascularization and in pre-existing blood vessels exposed to VEGF-A suggests that this receptor and possibly its ligands are recruited in VEGF-A-driven angiogenesis.

Animals↗

Second primary tumors in hereditary retinoblastoma: a register-based study, 1945-1997: is there an age effect on radiation-related risk?

OBJECTIVE: The aim of this study is to evaluate the influence of age at external beam irradiation (EBRT) on the occurrence of second primary tumors (SPTs) inside and outside the irradiation field in hereditary retinoblastoma patients. DESIGN: Cross-sectional study. PARTICIPANTS: The study included 263 hereditary retinoblastoma patients born in The Netherlands between 1945 and 1997. METHODS: A national register-based follow-up cohort study was performed on hereditary retinoblastoma patients. Information on therapy, age at irradiation, and location of SPT was obtained from the register. The Kaplan-Meier method calculated cumulative incidences of SPT in three subgroups: irradiation before (early EBRT) and after 12 months of age (late EBRT), and no irradiation. The Mantel-Cox method determined the statistical significance of differences between the cumulative incidence curves. MAIN OUTCOME MEASURES: Development of SPT inside and outside a precisely defined irradiation field in relation to age at irradiation. Our definition excluded pineoblastoma as SPT, because they constitute part of a trilateral retinoblastoma; in addition, they lie outside the field of irradiation. RESULTS: The cumulative incidence of SPT at the age of 25 years was 22% (95% confidence intervals 13%-34%) in the early EBRT group, 3% (0%-14%) in the late EBRT group, and 5% (1%-16%) in the nonirradiated group (Mantel-Cox overall: P = 0.001; between early and late EBRT, P = 0.04). However, in early irradiated patients, the incidence of SPTs inside and outside the irradiation field was similar (11%), and the difference between early and late EBRT in incidence of SPT inside the field of irradiation was less prominent than overall (11% vs. 3%: P = 0.37). Sensitivity analysis showed the results depended on the way SPT, irradiation field, and, especially, pineoblastomas are defined. CONCLUSIONS: Hereditary retinoblastoma confers an increased risk for the development of SPT, especially in patients treated with EBRT before the age of 12 months. However, the presence of similar numbers of SPTs inside and outside the irradiation field suggests that irradiation is not the cause. In other words, this study does not show an age effect on radiation-related risk. Rather, early EBRT is probably a marker for other risk factors of SPT.

Adolescent↗

An improved breast irradiation technique using three-dimensional geometrical information and intensity modulation.

BACKGROUND AND PURPOSE: In spite of the complex geometry of the breast, treatment planning for tangential breast irradiation is conventionally performed using two-dimensional patient anatomy information. The purpose of this work was to develop a new technique which takes the three-dimensional (3D) patient geometry into account. MATERIALS AND METHODS: An intensity-modulated radiotherapy (IMRT) technique was developed based on the division of the tangential fields in four multi-leaf collimator (MLC) shaped segments. The shape of these segments was obtained from an equivalent path length map of the irradiated volume. Approximately 88% of the dose was delivered by two open fields covering the whole treated volume. Dose calculations for the IMRT technique and the conventional technique were performed for five patients, using computer tomography (CT) data and a 3D calculation algorithm. A planning target volume (PTV) and ipsilateral lung volume were delineated in these CT data. RESULTS: All patients showed similar equivalent path length patterns. Analysis of the dose distribution showed an improved dose distribution using the IMRT technique. The dose inhomogeneity in the PTV was 9.0% (range 6.4-11.4%) for the conventional and 7.6% (range 6.5-10.3%) for the IMRT technique. The mean lung dose was reduced for the IMRT technique by approximately 10% compared with the conventional technique. CONCLUSION: A new breast irradiation technique has been developed which improves the dose homogeneity within the planning target volume and reduces the dose to the lung. Furthermore, the IMRT technique creates the possibility to improve the field matching in case of multiple field irradiations of the breast and lymph nodes.

Breast↗

Partial boosting of prostate tumours.

BACKGROUND AND PURPOSE: In this planning study we propose a class solution for partial boosting of prostate tumours. Treatment margins and rectum dose are similar to that of the conventional treatment and are supposed to have no direct link to the level of dose escalation. We also study the robustness of our class solution in the presence of geometrical deviations. METHODS AND MATERIALS: To study the specifications of the class solution ten patients with histologically confirmed prostate cancer were replanned. Besides a conventional plan for each patient, different partial boost plans were produced with an inverse treatment-planning tool. We also simulated treatment geometrical deviations to estimate their effect on partial boost plans. RESULTS: In our class solution we use three contours in our inverse treatment planning, which are based on the classical CTV. A three beam arrangement appeared to produce a dose distribution, which is comparable to that of a five or seven beam geometry. Comparison of partial boost plans and conventional plans indicated that all conditions for a partial boost plan could be satisfied with the proposed class solution. Simulation of treatment geometrical deviations showed that large random deviations have a minor effect on the overall dose distributions, while systematic deviations may decrease the boost dose and increase the rectal dose. CONCLUSIONS: We presented a class solution for partial boosting of prostate tumours in which the level of dose escalation is dealt with separately from the margin size and the nominal rectum dose. The framework put forward in this study allows practical introduction of intensity modulated radiotherapy in routine clinical practice using current standards of imaging and position verification.

Humans↗

Helicobacter pylori lipopolysaccharide hinders polymorphonuclear leucocyte apoptosis.

A prominent histologic feature of Helicobacter pylori infection is a dense infiltration of polymorphonuclear leukocytes (PMNL) in gastric mucosa. H. pylori lipopolysaccharide (LPS) has been recognized as a primary virulence factor evoking acute mucosal inflammatory reaction. Previous works have shown that H. pylori LPS immunologic activities are lower than those of enterobacterial LPS. However, the effect of H. pylori LPS on spontaneous PMNL apoptosis, and mechanisms by which this H. pylori LPS may promote PMNL survival remain to be established. In this study, we investigated, by both morphologic and biochemical approaches, the action of H. pylori LPS on PMNL apoptosis in vitro, using broth culture filtrates (BCF) of H. pylori strains with different genotypes. We found that BCF from H. pylori caused a significant delay in spontaneous PMNL apoptosis and this delay was independent of the VacA, cag pathogenicity island and urease status. We demonstrated that LPS in BCF is responsible for this effect because it was abrogated by the LPS antagonist B287 (a synthetic analog of Rhodobactersphaeroides lipid A). Moreover, BCF from H. pylori induced P42/44MAP kinase activation in PMNL. Similar results were obtained with BCF of an Escherichia coli strain. Taken together these data suggest that longer survival of PMNL induced by H. pylori LPS may increase gastric epithelium injury in H. pylori-associated diseases.

Apoptosis↗

Foot-to-foot bioelectrical impedance analysis: a valuable tool for the measurement of body composition in children.

OBJECTIVE: To determine the accuracy of foot-to-foot bioelectrical impedance analysis (BIA) and anthropometric indices as measures of body composition in children. DESIGN: Comparison of foot-to-foot BIA and anthropometry to dual-energy X-ray absorptiometry (DEXA)-derived body composition in a multi-ethnic group of children. SUBJECTS: : Eighty-two European, NZ Maori and Pacific Island children aged 4.9-10.9 y. MEASUREMENTS: DEXA body composition, foot-to-foot bioelectrical impedance, height, weight, hip and waist measurements. RESULTS: Using a BIA prediction equation derived from our study population we found a high correlation between DEXA and BIA in the estimation of fat-free mass (FFM), fat mass (FM) and percentage body fat (PBF) (r=0.98, 0.98 and 0.94, respectively). BIA-FFM underestimated DEXA-FFM by a mean of 0.75 kg, BIA-FM overestimated DEXA-FM by a mean of 1.02 kg and BIA-PBF overestimated DEXA-PBF by a mean of 2.53%. The correlation between six anthropometric indices (body mass index (BMI), ponderal index, Chinn's weight-for-height index, BMI standard deviation score, weight-for-length index and Cole's weight-for-height index) and DEXA were also examined. The correlation of these indices with PBF was remarkably similar (r=0.85-0.87), more variable with FM (r=0.77-0.94) and poor with FFM (r=0.41-0.75). CONCLUSIONS: BIA correlated better than anthropometric indices in the estimation of FFM, FM and PBF. Foot-to-foot BIA is an accurate technique in the measurement of body composition.

Absorptiometry, Photon↗

Obesity in Auckland school children: a comparison of the body mass index and percentage body fat as the diagnostic criterion.

OBJECTIVES: First, to determine obesity rates in Auckland school children according to their ethnic group using two different criteria: the body mass index (BMI) and percentage body fat (PBF) derived from bioelectrical impedance analysis (BIA). Second to examine the relationship between BMI and body composition across ethnic groups to determine if BMI references from European children accurately reflect obesity in other ethnic groups. DESIGN: A total of 2273 Auckland school children, aged 5-10.9 y had their height, weight and bioelectrical impedance measured. Using these measurements, each child's BMI, fat free mass, fat mass and PBF were derived. RESULTS: In all 14.3% of children were obese using the recommended definition of obesity (BMI) greater than the 95th percentile). There was no clinically significant difference in the relationship between BMI and body composition in different ethnic groups. Obesity rates varied with ethnicity (P<0.0001) and were higher in Pacific Island (24.1%) and Maori (15.8%) than in European children (8.6%). Obesity rates also varied with age (P<0.03), with the highest rates in older children. PBF levels were higher in females than males (P<0.0001). Using a definition of obesity based on percentage body fat (PBF>30%), obesity rates were higher in all ethnic groups. CONCLUSIONS: Obesity rates are high in Auckland school children and there are clear differences in obesity rates in different ethnic groups. If BMI criteria are used to define obesity in our population, we recommend the same standards be used for children of all ethnicities.

Age Factors↗

Longterm survival in acute rhinocerebral mucormycosis with giant cell arteritis and foreign body granulomas.

A case of rhinocerebral mucormycosis occurring in a 41-year-old man with insulin-treated diabetes mellitus is reported. Microscopically, biopsy samples obtained from the left ethmoid and middle turbinate sinuses contained fungi that formed mycotic granulomas associated with multinucleate giant cell arteritis. The multinucleate giant cells contained broad, infrequently septate hyphase consistent with mucormycosis. The patient received surgical debridement with extenteration of the left orbit, and intravenous liposome-encapsulated amphotericin B. After 12 months, examination of the patient revealed complete healing. Multinucleate giant cell granulomas and arteritis are only exceptionally associated with rhinocerebral mucormycosis, but these histologic findings may be correlated with a progressive disease with better prognosis.

Acute Disease↗

Feasibility of automatic marker detection with an a-Si flat-panel imager.

Here we study automatic detection of implanted gold markers relative to the field boundary in portal images for on-line position verification. Portal images containing 1-2 MU were taken with an amorphous silicon flat-panel imager. The images were obtained with lateral field at 18 MV. Both the detection success rate and the localization accuracy of markers of 1.0 and 1.2 mm diameter were determined with the help of a marker detection method based on a marker extraction kernel. A method for determining a fiducial reference point related to the field boundary was developed. Detection success rates were 0.99, 0.90 and 0.95 for markers of 1.2 mm diameter and 5 mm length, 1.0 mm diameter and 5 mm length and 1.0 mm diameter and 10 mm length respectively. The localization accuracy appeared to be better than 0.3 mm. The reference point could be reproduced with an accuracy equal to 1 pixel (0.5 mm at isocentre) within one fraction. During the first few seconds of a treatment fraction the field edge was not stable, which appeared to be an effect of the motion of the radiation source. Thanks to the use an a-Si flat-panel imager, on-line position verification using implanted gold markers becomes clinically feasible. We can use a clinically acceptable marker diameter as small as 1.0 mm. These markers can be automatically detected in portal images obtained with 1-2 MU relative to a stable reference point related to the field boundary.

Algorithms↗

Epithelial intestinal cell apoptosis induced by Helicobacter pylori depends on expression of the cag pathogenicity island phenotype.

Helicobacter pylori has been shown to induce chronic active gastritis and peptic ulcer and may contribute to the development of duodenal ulcer. Previous studies have shown that H. pylori mediates apoptosis of gastric epithelial cells via a Fas-dependent pathway. However, evidence for the induction of such a mechanism in intestinal epithelial cells (IEC) by H. pylori infection has not been demonstrated yet. This study was performed (i) to ascertain that H. pylori can induce IEC apoptosis; (ii) to delineate the role of the cag pathogenicity island (PAI), cagE, and vacA gene products in this process; and (iii) to verify whether the Fas-dependent pathway is involved in this phenomenon. When T84 cells were exposed to VacA(+)/cag PAI(+) H. pylori strains (CCUG 17874 and 60190), they exhibited apoptosis hallmarks as assessed by morphological studies, as well as annexin V and 3,3'-dihexyloxacarbocyanine iodide staining. In contrast, few or no apoptotic features could be detected after incubation with an isogenic mutant of strain 60190 in which the cagE gene was disrupted (60190:C(-) strain) or with a VacA(-)/cag PAI(-) H. pylori strain (G21). In addition, activation of caspase-3 during infection with VacA(+)/cag PAI(+) H. pylori strains was inhibited by pretreatment of IEC with an antagonistic anti-Fas antibody (ZB4). Taken together, these findings indicate that H. pylori triggers apoptosis in IEC via a Fas-dependent pathway following a process that depends on the expression of the cag PAI.

Apoptosis↗

Identification of a sea urchin Na(+)/K(+)/2Cl(-) cotransporter (NKCC): microfilament-dependent surface expression is mediated by hypotonic shock and cyclic AMP.

We report the identification of an invertebrate Na(+)/K(+)/2Cl(-) cotransporter, NKCC. As a model system, we used the immune cells (coelomocytes) of the Mediterranean sea urchin Paracentrotus lividus. These cells are particularly interesting because they can be activated to undergo a rapid and dynamic change in cell shape. We demonstrate that forskolin, a cyclic AMP agonist known to regulate NKCC, induced coelomocyte transformation at doses of 10 micromol l(-)(1) and greater. Using two distinct monoclonal antibodies (T4 and T9) raised against the human intestinal epithelial NKCC, we have identified a high-molecular-mass (195 kDa) protein in coelomocyte extracts. We propose a novel method for the isolation of NKCC in one step by using bumetanide-Sepharose affinity chromatography under low-[Cl(-)] conditions. This method was successful in isolating coelomocyte 195 kDa NKCC. The T4 monoclonal antibody was used in immunocytochemical experiments to localize NKCC in resting and activated coelomocytes. In petalloid coelomocytes, a punctate, cytoplasmic distribution was observed in close proximity to actin filament bundles; in transformed coelomocytes, the immunofluorescence was distributed along the length of the filopodia and uniformly throughout the perinuclear region. The change in subcellular distribution of NKCC between the resting and the activated state was further investigated by using cell surface biotinylation followed by immunoprecipitation. These studies revealed an upregulation of NKCC at the plasma membrane upon activation, a process that was blocked by the F-actin-stabilizing drug phalloidin. These studies identify a novel model system in which to investigate a newly identified invertebrate Na(+)/K(+)/2Cl(-) cotransporter.

Actin Cytoskeleton↗

[Ultrastructural features of peripheral choroidal neovascular membranes in age-related macular degeneration].

PURPOSE: Some neovascular membranes comprise two parts: a fibro - vascular central body and an avascular marginal component. Certain authors have suggested that this avascular part could be involved in post laser treatment recurrence of subfoveal membranes. The purpose of this study was to determine the ultrastructural features of the marginal avascular component. METHODS: Four well-defined subfoveal neovascular membranes associated with age-related macular degeneration were surgically excised. The peripheral portion of each membrane was evaluated by transmission electron microscopy for cellular and extracellular constituents. RESULTS: Each subretinal neovascular membrane was composed of two regions demonstrated by fluorescein angiography: a central area of hyperfluorescent leakage and an annular rim of hypofluorescence. The edge of the central body corresponded to a richly neovascularized tissue and was surfaced by a hyperplasic retinal pigmented epithelium. The rim was composed of a layer of retinal pigmented epithelium and a layer of photoreceptor outer segments associated with macrophages. The stroma was composed of fibrin and was avascular and acellular. DISCUSSION: Neovascular removal of membrane was surgically removed as well as native retinal pigmented epithelium beyond the surface of fibrovascular central body which could explain why post operative scar surfaces were larger than to the initial preoperative membrane defined by fluorescein angiography. CONCLUSIONS: The peripheral rim of neovascular membrane is an exsudative complication of the outer epithelium made up fibrin, native retinal pigmented epithelium, and photoreceptor outer segments. The front of the active neovascularization is localized in the periphery of the central fibrovascular body.

Choroidal Neovascularization↗

Lack of blood-brain barrier properties in microvessels of the prelaminar optic nerve head.

PURPOSE: To define the blood-brain barrier (BBB) characteristics of microvessels in the optic nerve head (ONH). METHODS: Immunohistochemical staining of different regions of the ONH, retro-laminar optic nerve, and retina of human and monkey eyes was carried out, using antibodies against BBB markers (glucose transporter 1, transferrin receptor, and P-glycoprotein), the non-BBB marker PAL-E, and against plasma proteins fibrinogen and IgG, which serve as endogenous markers of nonspecific microvascular permeability. In the ONH of monkey eyes, the number of transport-related endothelial pinocytotic vesicles and their cellular distribution within the microvessels were determined by electron microscopy. RESULTS: In both human and monkey eyes, only microvessels in the prelaminar region of the ONH were positive for the PAL-E antigen. The prelaminar region microvessels showed either no or weak expression of the transferrin receptor and P-glycoprotein but stained positive for glucose transporter 1. In human ONH, fibrinogen and IgG were present around microvessels in the prelaminar region but not in other parts of the optic nerve or retina. By electron microscopy, endothelial cells of prelaminar region microvessels contained a higher number of pinocytotic vesicles, located at the luminal and abluminal side of the endothelial cell membrane, in contrast to a mainly abluminal localization in microvessels of the retina and other parts of the optic nerve. CONCLUSIONS: Microvessels in the prelaminar region of the ONH lack classical BBB characteristics and display nonspecific permeability, possibly mediated by vesicular transport.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Pelvic ependymoma arising from the small bowel.

A 37-year-old woman underwent resection of an abdominal tumour which was adherent to the wall of the ileum. The diagnosis of an ependymoma was supported by evidence of typical perivascular pseudorosettes which stained positive for glial fibrillary acidic protein and contained abundant intermediate filaments within the elongated processes by electron microscopy. Flow cytometric study showed a diploid population of tumour cells. This is the first case of an ependymoma arising from the small bowel without any connection to the genital tract, the omentum or with the sacroccygeal area. As is the case with other unusual and ectopic localisations of ependymomas, prognosis of this tumour is difficult to evaluate.

Adult↗