1/85. A case of leptomeningeal metastasis from lung adenocarcinoma diagnosed by reverse transcriptase-polymerase chain reaction for carcinoembryonic antigen.A case of leptomeningeal metastasis from lung adenocarcinoma is reported. In this case, we evaluated the feasibility of reverse transcriptased polymerase chain reaction (RT-PCR) methods to detect cancer cells in cerebrospinal fluids (CSF). Messenger rna of carcinoembryonic antigen (CEA) was clearly demonstrated in CSF by reverse RT-PCR methods. An immunohistochemical study also demonstrated that tumor cells were stained positive with anti-CEA antibody. This case suggests that RT-PCR for CEA was a sensitive and useful method to diagnose leptomeningeal metastasis from lung adenocarcinoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/85. Clear cell meningioma of the lumbo-sacral spine with chordoid features.Clear cell meningioma (CCM) is a peculiar variant that differs from conventional meningioma in affecting younger patients, arising more often in spinal or cerebellopontine locations, and showing a higher recurrence rate. Classical meningothelial areas are scarce in these tumors and the differential diagnosis with other neoplasms, particularly metastatic carcinoma, is often difficult. We report a case of clear cell meningioma from the lumbosacral spine in which location, radiologic presentation, light microscopic appearance in initial sampling, and some of the ultrastructural findings were reminiscent of chordoma. The tumor cells were diffusely positive for vimentin and very focally positive for epithelial membrane antigen. Ultrastructural demonstration of interdigitating cell processes joined by numerous desmosomes confirmed the diagnosis of CCM.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
3/85. Metastatic meningioma in fine-needle aspiration (FNA) of the lung: cytomorphologic finding.Pulmonary metastasis of intracranial meningioma is rare. We present the cytomorphologic features of such a tumor in a 71 yr-old woman who was found to have multiple lung nodules 13 years following the resection of an atypical intracranial meningioma. Cytomorphologic features were quite distinct and included hypercellularity with large syncytial groups of monomorphic cells with epithelioid morphologic features, often in perivascular arrangements. Occasional intranuclear cytoplasmic inclusions as well as binucleated cells with wispy cytoplasmic extensions were also noted. Immunoperoxidase studies showed focal positivity for epithelial membrane antigen. The differential diagnosis includes primary or metastatic adenocarcinoma, malignant mesothelioma, and melanoma.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
4/85. Secretory meningioma of the brain. Report of two cases.Two cases of cerebral secretory meningioma, occurring in 57 and 33-year-old females are reported. The tumors were located in the tentorial and frontotemporal region, respectively. The general histologic appearance of the tumors was of meningothelial meningioma (case 1) and meningioma with microcystic and angiomatous features (case 2). The most striking histological finding in both tumors were numerous pseudopsammoma bodies, localized chiefly around blood vessels. The inclusions were slightly eosinophilic, stained strongly with PAS method and were differing in size from 3 to 30 microns. Tumor cells containing or surrounding pseudopsammomas were immunopositive for cytokeratin and epithelial membrane antigen. In the first case, individual pseudopsammomas were strongly positive for carcinoembryonic antigen. Some diagnostic aspects of this antigen and problems regarding differential diagnosis in secretory meningioma are briefly discussed.- - - - - - - - - - ranking = 0.6keywords = antigen (Clic here for more details about this article) |
5/85. meningioma of the fourth ventricle.Meningiomas are primary meningeal based tumors of the central nervous system that rarely are located strictly within the fourth ventricle. We report a 72-year-old man operated upon for such a tumor. The pre-operative magnetic resonance images revealed a well circumscribed mass in the fourth ventricle that exhibited a low signal on T1-weighted magnetic resonance images and homogenously enhanced with gadolinium. By light microscopy the tumor was composed of tightly packed spindle cells separated by collagen. immunohistochemistry showed the tumor cells to be positive for vimentin and epithelial membrane antigen, and negative for glial fibrillary acidic protein. Electron microscopy revealed typical findings of meningioma, including interdigitating cell processes, desmosomes, and intermediate filaments. Although rare, fibroblastic meningioma must be included in the differential diagnosis of a fourth ventricular spindle cell tumor in elderly patients.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
6/85. meningioma with granulofilamentous inclusions.The authors report a case of intracranial meningioma with granulofilamentous inclusions. A 50-year-old man had right trigeminal neuralgia due to trigeminal nerve compression by a petroclival tumor and received tumor resection. Microscopically, tumor cells containing eccentric nuclei and intracytoplasmic hyaline inclusions were arranged in sheets and whorls. The inclusions were negative for periodic acid-schiff reaction. No histological anaplasia was seen. immunohistochemistry showed epithelial membrane antigen reactivity on the cytoplasmic membrane. Immunoreactivity for vimentin was recognized in cytoplasm adjacent to inclusions. However, confocal laser microscopic study revealed immunoreactivity for vimentin even inside some inclusions. Ultrastructurally, interdigitation of cytoplasmic processes and desmosomes connecting adjacent cells were noted. Inclusions were composed of numerous fine osmiophilic granules attached by intermediates filaments. These findings were consistent with a meningioma with the granulofilamentous inclusions described earlier. The findings demonstrated by confocal laser microscopy and electron microscopy suggest that these granular materials may be the metabolic products of vimentin filaments.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
7/85. Clinicopathological features of solitary fibrous tumor of the meninges: An immunohistochemical reappraisal of cases previously diagnosed to be fibrous meningioma or hemangiopericytoma.Cases of solitary fibrous tumor (SFT) of the meninges are increasingly being reported. However, the real incidence of SFT among meningeal tumors has yet to be determined. We therefore clinicopathologically re-examined 64 meningeal tumors originally diagnosed to be either fibrous meningioma (FM group, n = 46) or hemangiopericytoma (HPC group, n = 18) while paying special attention to SFT. We thus reclassified one case from the FM group (2%) and one case from the HPC group (6%) to be SFT, both of which showed diffuse CD34-immunoreactivity and dense intercellular reticulin fibers but neither epithelial membrane antigen nor S-100 protein expression. The MIB-1 staining index of these cases were 6. 2% and 3.9%, respectively. The former recurred 15 years after the initial surgery and the patient underwent a second removal of the tumor. The patient has been alive with no evidence of recurrence for 7 years after the second surgery. The latter patient has been alive with no evidence of recurrence for 3 years postoperatively. The results confirmed that the incidence of SFT among meningeal tumors is relatively low, however, because of its clinically indolent nature, a careful histochemical examination is necessary to differentiate SFT from other neoplasms with a more aggressive nature. Our findings emphasize the need to clinically recognize this lesion as a distinct entity.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
8/85. Solitary fibrous tumor arising from the falx cerebri--case report.A 50-year-old female was admitted with headache and visual disturbance. neuroimaging demonstrated a well-demarcated large tumor attached to the falx cerebri. The tumor was totally removed by surgery. Histological examination showed that the tumor consisted of spindle cells with no pattern in the collagenous background. Staghorn-like blood vessels were common. Immunohistochemical study showed the tumor cells were strongly positive for CD34 and vimentin, but negative for epithelial membrane antigen. The diagnosis was solitary fibrous tumor arising from the falx cerebri. Solitary fibrous tumor is rare within the cranial cavity, and can be distinguished from meningioma and hemangiopericytoma by the histological, ultrastructural, and immunohistochemical findings.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
9/85. Intrathecal cytotoxic T-cell immunotherapy for metastatic leptomeningeal melanoma.A 49-year-old patient with primary, recurrent melanoma on the lower extremity developed metastatic leptomeningeal melanoma that did not respond to treatment with radiation therapy or intrathecal interleukin 2 (IL-2). disease was characterized by neurological symptoms, including loss of hearing, loss of short-term memory, and gait disturbance. CD8 CTLs were generated in vitro using autologous dendritic cells pulsed with peptides from the melanoma-associated antigens tyrosinase (145-156), Melan-A/MART-1 (26-35), and gp100/Pmel 17 (209-217). The CTLs exhibited up to 74% specific lysis against peptide-pulsed autologous EBV-transformed B cells, with Melan-A-specific CTLs yielding the greatest lytic activity. CD8 CTLs possessed a type 1 cytokine profile, expressing tumor necrosis factor alpha and IFNgamma but not IL-4. Infusions of CTLs were supported with systemic low-dose IL-2 administration. 111In labeling and computerized gamma imaging were used to monitor the distribution of CTLs up to 48 h after infusion. Intra-arterial delivery via the right carotid artery was followed by redistribution of the CTLs to the lungs, liver, and spleen within 16 h. In contrast, delivery via an indwelling Ommaya reservoir resulted in prolonged retention of CTLs within the brain for at least 48 h after infusion. Marked but transient elevations in tumor necrosis factor alpha, IFN-gamma, and IL-6 in the cerebrospinal fluid were observed within 4 h of CTL infusion. There was no evidence of tumor progression throughout the treatment period, and clinically the patient showed some resolution of neurological symptoms.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
10/85. Meningeal solitary fibrous tumor as an unusual cause of expohthalmos: case report and review of the literature.OBJECTIVE AND IMPORTANCE: We report an extremely rare case of a patient with meningeal solitary fibrous tumor with orbital involvement presenting as unilateral exophthalmos. This rare tumor should be considered in the differential diagnosis for aggressive dural-based lesions. CLINICAL PRESENTATION: A 54-year-old man presented with a protruded eyeball on the right side and left hemiparesis. Computed tomography and magnetic resonance imaging demonstrated a huge mass, markedly enhanced in and around the right anterior clinoid process, which extended to the orbit and middle cranial fossa. cerebral angiography revealed a richly vascular tumor fed by branches of both the right external and internal carotid arteries. A presumptive diagnosis of meningioma or hemangiopericytoma was considered. INTERVENTION: The tumor was exposed through an orbitozygomatic approach. At surgery, the tumor was grossly firm to hard and had destroyed the dura, orbital roof, anterior clinoid process, temporal bone, and muscle. Histological analysis revealed that the tumor was composed of spindle-cell proliferation in a collagen-rich background, but it exhibited regional variations. The vascular network demonstrated irregular vascular lumina with a "hemangiopericytoma-like" pattern. Histological features included high cellularity and a high degree of pleomorphism. Immunohistochemical analysis of the tumor demonstrated diffuse positive staining for CD34 and vimentin. The tumor displayed no positive staining for cytokeratin, epithelial membrane antigen, glial fibrillary antigenic protein, S-100 protein, and factor xiii. CONCLUSION: Meningeal solitary fibrous tumor is considered a unique pathological entity. Wider use of immunohistochemical screening should enable analysis of the real incidence of these tumors; larger series and longer follow-up duration will allow conclusions to be drawn regarding treatment and prognosis. Differential diagnosis is discussed and the literature is reviewed.- - - - - - - - - - ranking = 0.4keywords = antigen (Clic here for more details about this article) |
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