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Characterization of three restricted specificity monoclonal antibodies raised against the human glioma cell line D-54 MG.

Monoclonal antibodies ( MCAs ) have been derived from a fusion of P3-NS1/1-Ag 4-1 (NS1) myeloma cells and splenocytes immunized to human glioma cell line D-54 MG. MCAs 2F3 , 4C7 , and 5B7 were analyzed by cell surface radioimmunoassay (CS-RIA), quantitative absorption, indirect immunofluorescence, and peroxidase-anti-peroxidase (PAP) immunohistology of unfixed tissue samples. MCA 2F3 exhibits the most highly restricted pattern of reactivity we have observed, reacting only with 5/12 glioblastoma cell lines and 1/4 fetal skin lines by CS-RIA, and to 9/11 glioblastoma tissue samples by PAP and absorption analysis; this MCA is totally nonreactive with melanomas, neuroblastomas, meningiomas, and control non-central nervous system tumors, and to adult and fetal tissues including brain, thymus, spleen, liver, lung, heart, gut, skin, and muscle by PAP analysis. MCAs 4C7 and 5B7 demonstrate neuroectodermal tumor cross-reactivity profiles, reacting with either melanomas ( 5B7 ) or melanomas and neuroblastomas ( 4C7 ); both are reactive with fetal skin, brain, and thymus of less than or equal to 16 weeks of gestational age. Other than this latter fetal antigen reactivity, these MCAs share the same negative reactivity profile described above for MCA 2F3 . Data from experiments using control or 0.02% EDTA-treated confluent cell monolayers of D-54 MG as antibody absorbents showed that the antigens detected are present in the extracellular matrix material remaining following cell removal. The data presented here establish that these highly restrictive anti-human glioma cell line MCAs are expressed in primary human gliomas; that the markers defined are developmental in nature, in that they are expressed by human fetal tissue, but not by adult tissue; and that in conjunction with previously characterized specificities, these markers of antigenic heterogeneity will be valuable in model system studies of therapeutic response heterogeneity.

Absorption↗

Gangliosides modulate the development of ethyl-nitrosourea induced brain tumors in rats.

The possible effect of gangliosides as biological modifiers of the ethyl-nitrosourea (ENU) model of neurocarcinogenesis in rats is studied. Wistar rats that were exposed to ENU during fetal life, were treated with gangliosides at a postnatal age corresponding to a stage of pretumor or microtumor development. The results obtained suggest that postnatal administration of gangliosides can influence the development of ENU-induced brain tumors, delaying the appearance of symptomatic neoplasms and improving survival with respect to controls. This finding suggests the potential usefulness of gangliosides in the control of neuroectodermal tumors.

Animals↗

Clinico-morphological pattern of intracranial tumors in children.

OBJECTIVE: The objective of present study was to observe the histopathological pattern of intracranial tumors in children (< 15 yrs) and to correlate the site of lesion along with the histological diagnosis. SETTING: The study included consecutive cases of intracranial tumors diagnosed in children (< 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years. METHODS: The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated. RESULTS: During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma (18.6%) ranked the second most prevalent brain tumor followed by empendymoma (13%), oligodendroglioma 7.5% while non-Hodgkin's lymphoma, primitive neuroblastoma 3.7% and ganglioglioma 3.7% while non-Hodgkin's lymphoma, primitive neuroectodermal tumors, mixed germ cell tumor, pineoblastoma, choroid plexus carcinoma and malignant meningioma constituted 1.8% each. CONCLUSION: Astrocytoma was the most common pediatric brain tumor. Medulloblastoma was more common in males while pilocytic astrocytoma was more frequent in females. Posterior cranial fossa was the most common site (43.5%) of pediatric brain tumors. Low grade astrocytoma was more prevalent in posterior cranial fossa as compared to high grade astrocytoma which was more frequent in the supratentorial region.

Astrocytoma↗

Electron microscopy and other ancillary techniques in the diagnosis of small round cell tumors.

The current study disusses a new approach to the group of small round cell tumors (SRCTs) independently of their primary anatomical location. We perform this analysis supported mainly by morphological means and particularly with the help of immunohistochemistry and electron microscopy; the last of which continues to play a decisive role in their differential diagnosis. The microscopical similarity of many of these tumors often makes the diagnosis in routine histology extremely difficult, due to the varying degree of heterogeneity present, and may have important therapeutic and prognostic implications. Thus a correct final diagnosis is mandatory for the clinic. Within the group of tumors that express a dominant or occasional small round cell pattern "SRCT" (neoplasms of the Central Nervous System excluded) are included: Ewing's sarcoma and peripheral neuroectodermal tumor (Es/pPNET) comprising its varieties, neuroblastoma, desmoplastic small round cell tumor, rhabdomyosarcoma, alveolar, solid and embryonal, small cell osteosarcoma, chondrosarcoma, myxoid and mesenchymal, round cell and myxoid liposarcoma, synovial sarcoma (monophasic undiffentiated), primitive malignant peripheral nerve sheath tumor (malignant small cell schwannoma), malignant non-Hogdkin lymphoma, Merkel cell tumor of the skin (small cell carcinoma including neuroendocrine carcinoma). This study discusses in each case not only the histology, supported by immunohistochemistry, but also the main ultrastructural characteristics. We are conscious that in some cases further cytogenetic or molecular biology support may be necessary, when considering the limits of morphology today. Thus, short references on molecular genetics, complementing the structural findings, are given.

Humans↗

The evolution of clinical molecular genetics. Neuroblastoma as a model tumor.

The use of cytogenetics and molecular genetics to elucidate mechanisms underlying the pathogenesis of human cancer has led to important advances in our understanding of cancer etiology. The identification of a reciprocal (11;22) translocation in peripheral neuroectodermal tumors and N-myc amplification in classical childhood neuroblastoma provides new guidelines for the diagnostic evaluation of peripheral nervous system tumors. New approaches to the staging of these tumors are likely to include the evaluation of genetic alterations associated with tumor progression. Also, new therapeutic approaches will be focused on the modification of specific molecular targets responsible for neoplastic growth.

Cell Line↗

Malignant neoplasm of mixed mesenchymal and neuroepithelial origin (ectomesenchymoma) of thigh.

A 49-year-old man had a malignant soft tissue tumor of the right thigh with metastasis to the femoral region and lower quadrant of the anterior abdominal wall on the right side and the left supraclavicular lymph nodes. The neoplasm showed features of chondrosarcoma and primitive neuroectodermal tumor (combined neuroblastoma, ependymoma, astrocytoma, and oligodendroglioma). The gliomatous part of the mixed tumor was confirmed by identification of the glial fibrillary acidic protein (GFAP). The diverse cellular population suggests a tumor origin from the ectomesenchymal remnant of the neural crest. The mesenchymal component of the neural crest would differentiate into the chondrosarcoma and the neuroectodermal component into the primitive neuroectodermal neoplasm. These various neoplastic elements, then, would form a neoplasm of mixed mesenchymal and neuroepithelial origin or an ectomesenchymoma.

Astrocytoma↗

Melanoma-inhibiting activity (MIA/CD-RAP) is expressed in a variety of malignant tumors of mainly neuroectodermal origin.

BACKGROUND: The identification of tumor-specific antigens is an important topic for potential therapeutic and diagnostic applications. Melanoma-inhibiting activity (MIA/CD-RAP), a protein involved in the regulation of tumor growth, invasion, dissemination and immunoreactivity in melanomas and other tumors, is expressed by almost all melanomas and melanoma metastases screened to date so far. Elevated levels of melanoma-inhibiting activity (MIA/CD-RAP) have also been measured in a subgroup of patients with advanced stage breast carcinomas. MATERIALS AND METHODS: To further evaluate the extent and distribution of MIA/CD-RAP expression, early passage melanoma, glioma and other tumor cell lines as well as non-malignant cell lines were screened for the expression of MIA/CD-RAP by PCR, Western blot and immunohistochemistry. RESULTS: All melanomas tested (n = 19) expressed high levels of MIA mRNA and protein. A high incidence of MIA expression was also found in glial tumors (6 out of 27). In contrast, MIA message (mRNA) could not be detected in non-glial CNS-tumors (n = 13). In addition, in CSF of patients harboring a brain tumor, significant higher levels of MIA protein were detectable compared to the systemic values. MIA/CD-RAP-message was detectable in 7 out of 20 systemic tumors, mainly carcinomas of the colon (2 out of 2) and, in low levels, in 8 out of 20 normal non-transformed cell cultures, for example fibroblasts and peripheral lymphocytes. These data indicate that MIA/CD-RAP is widely expressed in human and murine primary cell cultures and cell lines, with nevertheless relative high specificity for melanocytic tumors. Measurements of MIA protein in the cerebrospinal fluid (CSF) and serum of patients harboring metastatic melanoma revealed higher levels in the CSF than in serum. To address functional aspects of MIA/CD-RAP expression, we stably transformed a MIA/CD-RAP-negative glial tumor cell line to express MIA/CD-RAP. When tested in colony forming assay (CFA), these clones showed a marked reduction in colony formation. CONCLUSION: According to these results, MIA/CD-RAP seems to exert a general function for invasive and metastatic tumors.

Central Nervous System Neoplasms↗

Human neuroblastoma cell lines that express N-myc without gene amplification.

BACKGROUND: About one half of aggressive neuroblastomas lack N-myc amplification. Cell lines from such tumors are needed to determine the biological basis of aggressive tumor behavior. METHODS: Neuroblastoma cell lines were established from a primary tumor (SMS-LHN) and a bone marrow metastasis (LA-N-6) of two children with Stage IV neuroblastoma. Although both cell lines and their original tumors lacked N-myc genomic amplification, these patients died of progressive disease. RESULTS: SMS-LHN and LA-N-6 can be distinguished from primitive neuroectodermal tumor (PNET) lines by cell surface antigen expression and catecholamine production. Cytogenetic analysis of each cell line revealed unique genetic rearrangements, whereas both lines showed abnormalities involving chromosome 2. Neither cell line contained double-minute chromosomes, homogeneously staining regions, a 1p chromosomal deletion, or t(11;22). The growth rates of these two new lines in vitro and in vivo (as xenografts in nude mice) are slower than N-myc amplified neuroblastoma lines. Both lines express greater amounts of N-myc RNA and protein relative to nonneuroblastoma cell lines (including PNET), although not to the extent of cell lines with N-myc genomic amplification. CONCLUSIONS: The relatively large amount of N-myc expression in these two new cell lines suggests that N-myc expression without amplification could play a role in the pathogenesis of some neuroblastomas. These cell lines should be useful for investigating mechanisms and consequences of N-myc gene activation other than genomic amplification.

Antigens, Neoplasm↗

Sinonasal small cell neoplasm developing after radiation therapy for retinoblastoma: an immunohistologic, ultrastructural, and cytogenetic study.

Patients with retinoblastoma have an increased risk of developing second primary tumors. Only a few examples of sinonasal small cell neoplasms developing after radiation therapy for retinoblastoma have been reported. We report one such case that developed 18 years after treatment for retinoblastoma. Histologic examination revealed a small, blue, round cell tumor without rosettes or cytoplasmic glycogen. Immunohistochemically, the tumor cells were positive for neuron-specific enolase, synaptophysin, and S-100 protein, but negative for epithelial and mesenchymal markers, suggesting that this was a primitive neuroectodermal tumor. Cytogenetic studies of this tumor failed to reveal the chromosome 13 abnormality typical of retinoblastoma and the t(11:22) translocation typical of the group of peripheral neuroepitheliomas.

Adult↗

DNA-aneuploidy in rhabdomyosarcomas as compared with other sarcomas of childhood and adolescence.

In the current study DNA-ploidy was determined in a group of 11 desmin-positive rhabdomyosarcomas and found to be aneuploid in all of them. In three cases, synchronous metastases could be studied as well. In two of them a hypotetraploid peak was observed not present in the primary tumor. In two other cases residual tumors obtained after chemotherapy appeared to have DNA-profiles similar to those observed in their primary tumors. These findings suggest either a selection of metastasizing clones or tumor progression. No apparent selection of clones responding to therapy could be established. For comparison, a group of other childhood sarcomas (four Ewing's sarcomas, two primitive neuroectodermal tumors, and two epithelioid sarcomas) was also studied. All except one of these cases appeared to have diploid or near-diploid stemlines. These results suggest that DNA-ploidy may be used as an additional criterion in the differential diagnosis of childhood sarcomas.

Adolescent↗

The MIC2 antibody 013. Practical application for the study of thymic epithelial tumors.

The lymphocytes that accompany thymomas express an immature T-cell phenotype, as usually demonstrated by CD1 or TdT immunoreactivity. Even when thymomas metastasize or occur in ectopic sites, the infiltrating T lymphocytes show this unique immature phenotype, contrasting with thymic and nonthymic carcinomas, in which the infiltrating T lymphocytes typically show a mature phenotype (CD1 and TdT negative). Therefore, the presence of an immature T-cell population in an epithelial tumor strongly supports a diagnosis of thymoma. The availability of an antibody that consistently marks immature T-cells in routine paraffin sections would be of great help in the study of thymic tumors. In this report, we describe the use of MIC2 antibody (013), which has been widely used for the diagnosis of Ewing's sarcomas and peripheral primitive neuroectodermal tumors because it intensely stains thymocytes. Immunohistochemical staining was performed on paraffin sections of normal/hyperplastic thymus (18 cases), thymoma (62 cases), thymic carcinoma (nine cases), tumors showing borderline features between thymoma and thymic carcinoma (three cases), and ectopic hamartomatous thymoma (two cases). T-cell and B-cell antibodies were also applied to aid in the interpretation. In the normal thymus, almost all lymphocytes in the cortex stained with 013, whereas fewer than 5% of those in the medulla were 013 positive. In thymomas, including the three ectopic thymomas and the single case of metastatic thymoma, most lymphocytes were 013 positive, except the spindle-cell foci (medullary thymoma or medullary component of mixed thymoma), in which the percentage of 013-positive lymphocytes was lower (5-30%). Within the pale foci of "medullary differentiation" and the perivascular spaces of lymphocyte-rich thymomas, few lymphocytes showed 013 positivity, indicating that the T lymphocytes in these areas were more mature. None of the thymic carcinomas harbored 013-positive lymphocytes. Among the three cases of borderline thymoma/thymic carcinoma, only one harbored 013-positive lymphocytes. The 013-positive lymphocytes were not seen in the ectopic hamartomatous thymomas. In normal lymph nodes and nonthymic carcinomas studied as controls, there were no or at most small numbers of isolated 013-positive lymphocytes. We conclude that interpreted in the proper context, MIC2 antibody can serve as a useful marker of immature T-cells and thus help in the confirmation of a diagnosis of thymoma in small biopsy specimens, ectopic thymoma, or metastatic thymoma; in the distinction between invasive thymoma and thymic carcinoma; and in the classification of thymomas.

12E7 Antigen↗

Exfoliative cytology of neuroendocrine small cell carcinoma of the endometrium. A report of two cases.

BACKGROUND: In the female genital tract, neuroendocrine small cell carcinoma can occur in the endometrium as well as the cervix, ovary and vagina. This tumor has a high propensity for systemic spread and a poor prognosis. Small cell carcinoma of the endometrium is cytologically identical to its counterparts in the lung and other sites. Its characteristic appearance in a cervicovaginal smear should raise concern about small cell carcinoma. Other tumors of the uterus should be considered in the differential diagnosis, including adenocarcinoma with neuroendocrine features, small cell nonkeratinizing squamous cell carcinoma, endometrial stromal sarcoma, rhabdomyosarcoma, primitive neuroectodermal tumor, non-Hodgkin's lymphoma and metastatic breast carcinoma. CASES: Case 1 was a 59-year-old, white female, and case 2 was a 47-year-old, white female. Both patients presented with vaginal bleeding. The Papanicolaou smears in both cases had similar, characteristic exfoliative cytology. The tumor cells were small and either single or arranged in groups and files. They had barely visible cytoplasm, darkly staining nuclei with finely stippled chromatin, and inconspicuous nucleoli. The characteristic molding of the nuclei was also present. Immuno-histochemical staining for neuron-specific enolase and synaptophysin was positive in tissue sections. Pancytokeratin, vimentin, muscle-specific actin, desmin, alpha-fetoprotein, S-100, glial fibrillary acid protein, common leukocyte antigen and chromogranin were negative. CONCLUSION: When a uterine small cell carcinoma is suspected in a cervicovaginal smear, the similarity of cervical and endometrial small cell carcinoma requires a differential curettage and immunohistochemical demonstration of neuroendocrine differentiation in order to arrive at the final diagnosis.

Biomarkers, Tumor↗

[Clinical pharmacokinetics of 2-C14-ftorafur in patients with astrocytoma].

Patients with dedifferentiated brain astrocytoma during an operation were injected intravenously 2-C14-fluorofur (3 muC/Kg). In different periods after the injection the level of radioactivity was determined in different sites of the tumor, brain tissue, as well as in blood plasma, cerebrospinal liquor and urine. Intracellular localization of the labeled substance in the tumor tissue was examined autohistoradiographically. 2-C14-fluorofur was found to readily penetrate the hemato-encephalic barrier and to be absorbed both by tissues of neuroectodermal tumor and adjacent brain tissues. In astrocytoma cells the labelled substance is localized mainly extranuclearly. Radioactive products are excreted from the organism slowly and their traces are observed in blood, cerebrospinal liquor and urine even on the third day postoperatively.

Astrocytoma↗

Neural differentiation in small round cell tumors of bone and soft tissue with the translocation t(11;22)(q24;q12): an immunohistochemical study of 11 cases.

Clinical, cytogenetic, histopathologic, and immunohistochemical data were obtained in a series of 11 small round cell tumors (SRCT) of bone and soft tissue with the translocation t(11;22) (q24;q12). Ten cases were primary in bone, and one was of extraskeletal origin. According to conventional histopathologic criteria, 10 cases were Ewing's sarcomas (ES) and one was a peripheral neuroectodermal tumor (PNET). Besides the t(11;22), six cases had additional chromosomal aberrations, including trisomy 7 and partial trisomy for the long arm of chromosome 1, which have both been described as nonspecific secondary abnormalities often associated with tumor progression. The tumors were screened for neural differentiation with an antibody panel consisting of neuron-specific enolase, S100 protein, Leu-7, chromogranin, synaptophysin, and neurofilament. Three cases of ES were positive for S100 protein. The PNET and one case of ES were positive for neuron-specific enolase. All of the remaining immunohistochemical stains were negative. Hence, five of 11 SRCT of bone or soft tissue with the t(11;22) showed morphologic and/or immunohistochemical evidence of neural differentiation. In this limited series of cases, no cytogenetic or prognostic differences could be demonstrated between cases with and without a neural phenotype. Our results support the hypothesis that SRCT of bone of soft tissue with the t(11;22) form a single biologic entity displaying varying degrees of neuroectodermal differentiation. The clinical significance of additional cytogenetic abnormalities and of morphologic or immunohistochemical evidence of neural differentiation in this group of tumors needs to be further studied.

Adolescent↗

Proliferating cell nuclear antigen immunoreactivity in human central nervous system neoplasms.

Formalin-fixed, paraffin-embedded surgical specimens from 140 primary human central nervous system tumors, including 51 meningiomas, 26 astrocytomas, 26 anaplastic astrocytomas, 9 glioblastomas, 1 gliosarcoma, 8 oligodendrogliomas, 5 ependymomas, 2 subependymomas, 9 medulloblastomas, and 3 paragangliomas, were immunostained using a streptavidin/peroxidase method and the PC10 monoclonal antibody, which recognizes an epitope on the proliferating cell nuclear antigen (PCNA). The following PCNA labeling index (LI) mean values were found for the above neoplasms: meningiomas, 3.80 +/- 7.35%; astrocytomas, 0.65 +/- 1.03%; anaplastic astrocytomas, 8.46 +/- 7.95%; glioblastomas, 10.26 +/- 11.21; gliosarcoma, 46.34%; oligodendrogliomas, 2.31 +/- 3.59%; ependymomas, 1.12 +/- 2.10%; medulloblastomas, 23.91 +/- 11.95%; and paragangliomas, 2.07 +/- 1.86%. Collectively, our findings indicate that while benign central nervous system tumors generally have low PCNA LI values, consistent over-expression of PCNA epitopes was noted in some examples, especially in a number of meningiomas. Among the malignant neuroectodermal tumors, medulloblastomas were found to have the highest PCNA LI values, corresponding to their histological grade of malignancy, and malignant glial tumors generally displayed significantly higher PCNA LI values, than their benign counterparts. Although in our study mean PCNA LI values seemed to reflect histological grading, large discrepancies were noted in all tumor groups. Our data, therefore, suggest than PCNA immunoreactivity can not be considered reliable for predicting the prognosis of the disease in individual cases.

Antigens, Neoplasm↗

Metastatic Ewing sarcoma masquerading as olfactory neuroblastoma.

Ewing sarcoma is a malignant tumor of bone that rarely spreads to the head and neck. We describe an unusual case of metastatic Ewing sarcoma involving the calvarium mimicking olfactory neuroblastoma, an uncommon neuroectodermal tumor of the anterior skull base. Pertinent clinical, radiological, and pathologic features of these tumors are described, with particular attention to their imaging characteristics.

Adult↗

Resection of a tumor of the psoas muscle.

A 16-year-old boy presented with paresthesias and weakness of the right thigh. A computerized axial tomography scan identified a mass within the right psoas muscle, and a needle biopsy showed a primitive neuroectodermal tumor, which did not respond to two courses of chemotherapy (Adriamycin, vincristine, and cytoxan). An anatomic resection of the psoas muscle and femoral nerve was performed and radiotherapy administered. The boy remains ambulatory and free of disease 2.5 years after resection.

Adolescent↗

Malignant chest wall tumors in children and young adults.

PURPOSE: Primary chest wall malignancies, which occur infrequently in children, can pose complex technical challenges to the surgeon. This study was undertaken to evaluate the pathology, treatment approaches, role of surgical resection and reconstruction, and outcomes of patients with these tumors. METHODS: This is a retrospective review of all patients with malignant primary chest wall tumors treated at our institution between February 1983 and July 1998. RESULTS: Nineteen cases were identified: malignant small round cell type (MSRCT, also called Ewing's sarcoma, primitive neuroectodermal tumor [PNET], and Askin's tumor; n = 8), rhabdomyosarcoma (RMS; n = 6), and other tumors (n = 5). Three patients underwent "upfront" complete resections. Sixteen patients underwent initial biopsy, followed by chemo- or radiotherapy. Nine of these 16 survived to undergo delayed chest wall resections. Six of the 12 "resected" patients required en bloc resection of adjacent muscles or organs; 7 required complex chest wall reconstruction. Eight of 19 patients (42%) have survived (median follow-up of survivors, 4 years), all with no evidence of disease; the remaining 11 patients died of progressive disease. Local invasion did not alter chance of survival. Two of the 10 patients with metastases at diagnosis (20%) survived. Six of the 9 patients (67%) with localized disease survived. All five patients with tumor types other than MSRCT or RMS, metastatic or not at diagnosis, are alive with no evidence of disease. There were no local recurrences. CONCLUSION: Surgical resection, with en bloc removal of involved structures and chest wall reconstruction, provides excellent local control of malignant chest wall tumors.

Adolescent↗