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  • 1
    Electronic Resource
    Electronic Resource
    Ependymoma of the Cauda Equina (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 781-782 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Myxopapillary ependymoma; proliferation; recurrence; pulmonary metastasis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Myxopapillary ependymomas are benign tumours which occasionally metastasize along cerebrospinal fluid pathways. Extraneural metastases of spinal ependymomas, however, are very rare, even more so when situated in the pleura.  We report the case of a 67 year old woman presenting with shortness of breath after recurrent myxopapillary ependymomas of the cauda equina. Chest X-ray showed multiple pleural lesions diagnosed as metastases of a myxopapillary ependymoma. The MIB-1 proliferation index was 3.1% for the initial spinal tumour, 14.2% for the first and 11.2% for the second recurrence while 12.0% for the pleural metastasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050376
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  • 2
    Electronic Resource
    Electronic Resource
    Primary malignant rhabdoid tumours of the central nervous system: An immunohistochemical and ultrastructural study (1997)
    Springer
    Acta neurochirurgica 139 (1997), S. 961-969 
    Details
    ISSN: 0942-0940
    Keywords: Malignant rhabdoid tumour ; atypical teratoid/rhabdoid tumour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three cases of primary rhabdoid tumour of the CNS (RT-CNS) are presented. In case 1 a hemispheric tumour developed in a 10.5 months old girl, who survived for 6 months after incomplete resection, radio- and polychemotherapy. Case 2 was a 4 years and 8 months old boy with a large IIIrd ventricle tumour, who died of leptomeningeal tumour dissemination 7 months after diagnosis despite radiotherapy. In case 3 a pineal mass occurring in a 14 month old female was radioresistant and totally exstirpated. The child died due to tumour recurrence two months later. Autopsy examination revealed widespread leptomeningeal dissemination. All three cases fulfilled light and electron microscopic criteria of RT-CNS including abundant eosinophilic cytoplasm, vesicular nuclei with large nucleoli and conspicuous anti-vimentin positive filaments. Extensive immunohistochemical studies showed expression of epithelial (EMA, KL1), macrophage (alpha-1 antichymotrypsin), neuro-ectodermal (GFAP, NSE, β-tubulin III) and myogenic markers (desmin, actin). Different stress proteins (alpha-B crystallin, HSP70) were also expressed. Tumour cells showed a proliferation (MIB1) index of 28.4% (case 1) and 33.4% (case 2). From our study it can be concluded that RT-CNS reveals significant immuno-morphological heterogeneity thus supporting the view that it is not a specific pathological entity but merely a phenotypic appearance of different neoplasms, some of which are linked to primitive neuro-ectodermal tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411306
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  • 3
    Electronic Resource
    Electronic Resource
    Morphological and immunohistochemical characterization of granular cells in non-hypophyseal tumours of the central nervous system (1997)
    Oxford, U.K. and Cambridge, USA : Blackwell Science Ltd
    Histopathology 30 (1997), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report 14 biopsy cases of granular cell tumours (GCT) of the central nervous system (CNS) outside the pituitary gland. In six cases the granular cells determined the morphology (actual GCT), the other eight consisted of different CNS tumours with a varying granular cell component. Pronounced immunoreactivity for ubiquitin and alpha-1-antichymotrypsin could be found in all investigated tumours, while GFAP, neuron specific enolase, von Willebrand factor, vimentin, S-100 protein, alpha-1-antitrypsin, actin, and the neurofilaments 68 kDa and 160 kDa showed mostly weak positivity in some cases. Four out of eight GCT showed no immunoreactivity for MIB1; the other four cases had a proliferation index between 0.5% and 15%. Six out of nine cases were positive for p53. We consider granular cells to originate from different cell types. Thus, although morphologically identical, GCT are actually biologically heterogeneous. GCT of the CNS may represent gliomas of mostly astrocytic origin with a metabolically induced transformation of some tumour cells into granular cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2559.1997.5360788.x
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  • 4
    Electronic Resource
    Electronic Resource
    Dysembryoplastic neuroepithelial tumour of the cerebellum (1995)
    Springer
    Acta neuropathologica 89 (1995), S. 385-390 
    Details
    ISSN: 1432-0533
    Keywords: Key words Dysembryoplastic neuroepithelial tumour ; Cerebellum ; Cerebellar astrocytoma ; Granule neurons
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of dysembryoplastic neuroepithelial tumour of the cerebellum occurring in a 28-year-old woman is presented. The lesion extended from the cortex of the inferior vermis upwards into the white matter. Histologically, it exhibited areas of microcystic cerebellar astrocytoma and glial regions with hamartomatous blood vessels as well as areas with oligodendrocyte-like cells (OLC) with a delicate, fibrillary stroma lying in a mucinous, often microcystic matr ix. The OLC showed prominent rosette formation and immunohistochemical features suggesting neuronal, i.e. granule cell, differentiation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00309634
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  • 5
    Electronic Resource
    Electronic Resource
    Prolaktinbildendes Hypophysenkarzinom Kasuistik eines äußerst seltenen metastasierenden Tumors* (1995)
    Springer
    Der Pathologe 16 (1995), S. 354-358 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Hypophysenkarzinom ; Lebermetastase ; Hyperprolaktinämie ; Key words Pituitary adenoma ; Prolactin-secreting pituitary carcinoma ; Metastasizing tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 59-year-old male patient was transnasally operated on because of a pituitary adenoma with hypopituitarism. A second operation and X-ray therapy followed a half year later due to recurrent tumor. Both neoplasmas were classified as sparsely granulated prolactin cell adenomas. Immunohistochemical studies revealed strong immunoreactivity for prolactin and FSH in the tumor cells of both the pituitary adenoma and the recurrent tumor. Two years later the prolactin plasma levels were extremely elevated. A tumor in the liver was identified. Biopsy revealed a solid endocrine tumor containing prolactin by immunohistology. Due to structural and immunohistological similarities this tumor could be identified as a metastasis of the pituitary tumor. After 5 months of therapy the patient died from thrombembolism. Post-mortem studies confirmed the diagnosis of a metastasizing prolactin-secreting pituitary carcinoma. Only six similar cases have been reported in the literature. Our case report confirms the experience with 35 definite pituitary carcinomas reparted in the current literature: malignant pituitary tumors develop after pituitary surgery and can be identified not from the pituitary tumor, but only from its metastases.
    Notes: Zusammenfassung Ein 59 jähriger Mann wurde wegen eines zu einer Hypophyseninsuffizienz führenden Hypophysenadenoms transnasal operiert, ein halbes Jahr später wegen residualen Adenomgewebes nachoperiert und anschließend einer Strahlentherapie unterzogen. Der Tumor wurde als gering granuliertes Hypophysenadenom vom Prolaktinzelltyp mit Prolaktin- und FSH-Bildung klassifiziert. Zwei Jahre später wurde bei einer extrem hohen Hyperprolaktinämie ein Lebertumor festgestellt, der sich im Biopsat als solider endokriner Tumor mit immunhistochemisch nachgewiesener Prolaktinbildung herausstellte. Wegen der strukturellen Ähnlichkeit und des weitgehend identischen Markerverhaltens mußte er als Metastase des Hypophysentumors angesehen werden. Nach fünfmonatiger Therapiedauer verstarb der Patient an den Folgen von thrombembolischen Komplikationen. Die Sektion konnte die Diagnose eines metastasierenden prolaktinbildenden Karzinoms bestätigen, da weitere extrahepatische Tumormanifestationen und somit mögliche alternative Primärtumoren nicht darstellbar waren. Der Fall ist mit nur 6 anderen bisher beschriebenen Kasuistiken weitgehend vergleichbar und bestätigt die Erfahrung aus 35 in der moderneren Literatur gesicherten Hypophysenkarzinomen, daß maligne Hypophysentumoren erst nach Hypophysenoperationen manifest werden und nicht am Primärtumor, sondern nur an den Metastasen diagnostiziert werden können.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050114
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  • 6
    Electronic Resource
    Electronic Resource
    Paraneoplastische limbische Enzephalitis (1997)
    Springer
    Der Pathologe 18 (1997), S. 406-410 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Paraneoplastische neurologische Syndrome ; Limbische Enzephalitis ; Anti-Hu-Syndrom ; Kleinzelliges Bronchialkarzinom ; Key words Paraneoplastic neurological syndromes ; Limbic encephalitis ; Anti-Hu-syndrome ; Small cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We report on a 69-year old male patient who presented with vague depressive symptoms and loss of weight accompanied by lack of appetite, ageusia and anosmia. The patient died of bronchial pneumonia, and neuropathological examination revealed a so-called limbic encephalitis. The paraneoplastic origin of this case was later confirmed by discovery of a clinically inapparent, indolently growing small cell lung cancer. This case illustrates the difficult clinical diagnosis of paraneoplastic limbic encephalitis and the need for a close cooperation of pathologists and neuropathologists in the clarification of such cases.
    Notes: Zusammenfassung Berichtet wird über den Fall eines 69jährigen Mannes mit einer unklaren depressiven Symptomatik und Gewichtsabnahme in Verbindung mit Appetitlosigkeit, Ageusie und Anosmie. Der Patient verstarb an einer Bronchopneumonie, und die neuropathologische Untersuchung ergab den Befund einer sog. limbischen Enzephalitis. Die paraneoplastische Genese des Krankheitsbildes wurde dann a posteriori durch den Nachweis eines klinisch unbekannten, lokal indolent wachsenden kleinzelligen Bronchialkarzinoms bestätigt. Der Fall illustriert die schwierige klinische Diagnose einer paraneoplastischen limbischen Enzephalitis und unterstreicht die Notwendigkeit einer engen Zusammenarbeit von Pathologen und Neuropathologen in der Aufklärung derartiger Fälle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050234
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  • 7
    Electronic Resource
    Electronic Resource
    Neurozystizerkose (1995)
    Springer
    Der Pathologe 16 (1995), S. 348-353 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Neurozystizerkose ; Zerebrale Verkalkungen ; Immuntoleranz ; Hydrozephalus ; Hirninfarkt ; Key words Neurocysticercosis ; Cerebral calcification ; Immuntolerance ; Hydrocephalus ; Cerebral infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 54-year-old female patient with a 10-year history of ventriculoperitoneal shunt resulting from communicating hydrocephalus of undetermined aetiology is reported. Transient gait disturbances and cerebral infarction at the age of 46 did not lead to further insights into the nature of the disease. After many years with only occasional disturbances, a distinct organic brain syndrome developed. Thorough examination led to a tentative diagnosis of neurocysticercosis; this was based on the history, liquor diagnosis and cerebral microcalcifications in CT. Despite the initiation of specific therapy, the patient died of the sequelae of the disease. At autopsy, characteristic cicatricial residues of mainly basal leptomeningitis were found with collapsed parasitic cysts. Additional intracerebral mesenchymal-glial reactions were less conspicuous. Residual ependymitis had caused aqueductal stenosis. Death was due to cachexia, bronchopneumonia and a lung abscess. The clinical course and morphology of neurocysticercosis are discussed. The disease has become rare in our country, but is globally the most important parasitic disease of the central nervous system.
    Notes: Zusammenfassung 54 jährige Patientin mit bereits 10 Jahre altem ventrikuloperitonealem Shunt wegen eines ätiologisch unklaren Hydrocephalus communicans. Eine passagere Gangstörung und ein Hirninfarkt mit 46 Jahren führten zu keiner weiteren Klärung der Krankheitsgenese. Nach langjähriger Zwischenphase mit gelegentlicher Verwirrung der Patientin trat ein ausgeprägtes hirnorganisches Psychosyndrom auf. Eingehende Diagnostik ergab aufgrund der Anamnese, der Liquor- und der CT-Befunde mit nachweisbaren kleinen zerebralen Verkalkungen den Verdacht auf eine Neurozystizerkose. Die Patientin starb trotz eingeleiteter spezifischer Therapie an den Folgen der Erkrankung. Bei der Obduktion zeigen sich charakteristische narbige Residuen einer v. a. basalen Leptomeningitis mit kollabierten Parasitenzysten. Zusätzliche intrazerebrale mesenchymal-gliöse Residuen waren weniger auffällig. Eine abgelaufene Ependymitis war Ursache einer Aquäduktstenose. Todesursache waren eine Kachexie, Bronchopneumonie und ein Lungenabszeß. Diskutiert werden Klinik, Verlauf und Morphologie der Neurozystizerkose, die – bei uns selten geworden – weltweit die wichtigste parasitäre Erkrankung des ZNS darstellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050113
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  • 8
    Electronic Resource
    Electronic Resource
    Paragangliom der Cauda equina (1997)
    Springer
    Der Pathologe 18 (1997), S. 484-487 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Paragangliom ; Ependymom ; Filum terminale ; Cauda equina ; Differentialdiagnose ; Key words Paraganglioma ; Ependymoma ; Filum terminale ; Cauda equina ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We report on a case of paraganglioma of the cauda equina in a 48-year-old man. These slow-growing, mostly benign and encapsulated intradural–extramedullar tumours are clinically characterized by lumbago, paraesthesia and motor deficits as well as occasi-onally by incontinence. Paragangliomas of the cauda equina show monomorphous (main) cells arranged in a typical cell cluster pattern, demonstrating a lobular architecture and a fine net of connective tissue formed by so-called sustentacular cells; some tumours show focal ganglionic differentiation. Because of their morphological similarity to the more common ependymomas, paragangliomas of the cauda equina are sometimes misdiagnosed so that their incidence is likely to be higher than previously estimated. Immunohistochemistry findings are positive for neuron-specific enolase, chromogranin and other neuronal markers as well as neuropeptides (main cells) and S-100 protein (sustentacular cells) while widely lacking reactivity for GFAP. Paragangliomas of the cauda equina represent a rare entity, of which only 80 cases have been described in the literature. Because they only occur sporadically, they are often not included in the differential diagnosis of mass lesions of the region of the cauda equina.
    Notes: Zusammenfassung Wir berichten über ein Paragangliom der Cauda equina bei einem 48jährigen Patienten. Klinisch imponieren diese langsam intradural-extramedullär wachsenden, meist benignen und von einer bindegewebigen Kapsel umgebenen Geschwülste durch Lumbalgien, Parästhesien und Paresen sowie gelegentlich durch Inkontinenz. Paragangliome der Cauda equina zeichnen sich histomorphologisch durch monomorphe Zellen (Hauptzellen) in typischer „Zellballen”-anordnung mit lobulärer Architektur und feinem Bindegewebsnetz aus Hüllzellen (Sustentakularzellen) aus, z.T. liegt eine ganglionäre Differenzierung vor. Wegen ihrer Ähnlichkeit zum häufigeren Ependymom werden sie mitunter fehldiagnostiziert, so daß ihre Inzidenz wahrscheinlich höher ist als bislang angenommen. Immunhistochemisch exprimieren sie neuronspezifische Enolase, Chromogranin und andere neuronale Marker sowie Neuropeptide (Hauptzellen) und S-100-Protein (Sustentakularzellen) bei weitgehend fehlender Reaktion für GFAP. Das Paragangliom der Cauda equina ist eine seltene Entität, von der bislang erst 80 Fälle in der Literatur beschrieben worden sind und an der gerade aufgrund ihres sporadischen Auftretens bei der Differentialdiagnose von Raumforderungen in diesem Bereich oft nicht gedacht wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050247
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  • 9
    Electronic Resource
    Electronic Resource
    Congenital immature teratoma of the fetal brain (1997)
    Springer
    Child's nervous system 13 (1997), S. 556-559 
    Details
    ISSN: 1433-0350
    Keywords: Key words Fetus ; Brain tumor ; Congenital ; Teratoma ; Immunohistochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Congenital intracranial tumors are very rare and only account for 0.5–1.5% of all childhood brain tumors. Even rarer are those with prenatal manifestation. The most common of these present at birth are teratomas, which show divergent differentiation with 90% of them containing tissues from all three germ layers. We report a rare case of an intrauterine congenital immature teratoma in a female fetus at 23 weeks of gestation, which was sonographically diagnosed in vivo by detection of the tumor and associated craniomegaly. Because of the poor prognosis, termination of the pregnancy was induced by Rivanol instillation. The cerebral tumor was confirmed at autopsy and was not associated with any other malformations. Histological and immunohistochemical features of this tumor are presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050137
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  • 10
    Electronic Resource
    Electronic Resource
    Dysembryoplastic neuroepithelial tumour of the cerebellum (1995)
    Springer
    Acta neuropathologica 89 (1995), S. 385-390 
    Details
    ISSN: 1432-0533
    Keywords: Dysembryoplastic neuroepithelial tumour ; Cerebellum ; Cerebellar astrocytoma ; Granule neurons
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of dysembryoplastic neuroepithelial tumour of the cerebellum occurring in a 28-year-old woman is presented. The lesion extended from the cortex of the inferior vermis upwards into the white matter. Histologically, it exhibited areas of microcystic cerebellar astrocytoma and glial regions with hamartomatous blood vessels as well as areas with oligodendrocyte-like cells (OLC) with a delicate, fibrillary stroma lying in a mucinous, often microcystic matrix. The OLC showed prominent rosette formation and immunohistochemical features suggesting neuronal, i.e. granule cell, differentiation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00309634
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