Imprints, Smears, and Frozen Sections of Brain Tumors

Neurosurgery ◽  
1991 ◽  
Vol 29 (4) ◽  
pp. 575-579 ◽  
Author(s):  
Marc G. Reyes ◽  
Fayez M. Homsi ◽  
Larry W. McDonald ◽  
Roberta P. Glick
Keyword(s):  
Spinal Cord ◽  
Middle Fossa ◽  
Frozen Sections ◽  
Spinal Cord Tumors ◽  
Paraffin Sections ◽  
Intraoperative Diagnosis ◽  
The Central Nervous System ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Brain And Spinal Cord

Abstract In this study, we compared the suitability and accuracy of imprints, smears, and frozen sections of suspected brain and spinal cord tumors of 150 patients. Eighty-six percent of the imprints, 91% of the smears, and 99% of the frozen sections were suitable for interpretation. Among the suitable preparations, 82% of the imprints, 92% of the smears, and 99% of the frozen sections agreed with our diagnosis on paraffin sections. Although frozen sections were clearly more accurate than imprints and smears, the latter two provided diagnoses in patients with acquired immunodeficiency syndrome where frozen sections were not done to avoid contaminating our cryostat and in a patient with an epidermoid cyst of the middle fossa that could not be adequately frozen sectioned. Our study shows that imprints and smears complement frozen sections in the intraoperative diagnosis of tumors of the central nervous system.

scholarly journals Molecular Biomarkers of Brain and Spinal Cord Astrocytomas

Acta Naturae ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 17-27 ◽  
Author(s):  
N. A. Konovalov ◽  
D. S. Asyutin ◽  
E. G. Shayhaev ◽  
S. V. Kaprovoy ◽  
S. Yu. Timonin
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Molecular Markers ◽  
Prognostic Value ◽  
Retrospective Studies ◽  
Genetic Mutations ◽  
Spinal Cord Tumors ◽  
Diagnosis And Classification ◽  
The Central Nervous System ◽  
Brain And Spinal Cord

Spinal cord astrocytomas are rare diseases of the central nervous system. The localization of these tumors and their infiltrative growth complicate their surgical resection, increase the risk of postoperative complications, and require more careful use of radio- and chemotherapy. The information on the genetic mutations associated with the onset and development of astrocytomas provides a more accurate neoplasm diagnosis and classification. In some cases, it also allows one to determine the optimal methods for treating the neoplasm, as well as to predict the treatment outcomes and the risks of relapse. To date, a number of molecular markers that are associated with brain astrocytomas and possess prognostic value have been identified and described. Due to the significantly lower incidence of spinal cord astrocytomas, the data on similar markers are much more sparse and are presented with a lesser degree of systematization. However, due to the retrospective studies of clinical material that have been actively conducted abroad in recent years, the formation of statistically significant genetic landscapes for various types of tumors, including intradural spinal cord tumors, has begun. In this regard, the purpose of this review is to analyze and systematize the information on the most significant genetic mutations associated with various types of astrocytomas, as well as discuss the prospects for using the corresponding molecular markers for diagnostic and prognostic purposes.

scholarly journals Comparisons of neuroinflammation, microglial activation, and degeneration of the locus coeruleus-norepinephrine system in APP/PS1 and aging mice

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Song Cao ◽  
Daniel W. Fisher ◽  
Guadalupe Rodriguez ◽  
Tian Yu ◽  
Hongxin Dong
Keyword(s):  
Spinal Cord ◽  
Locus Coeruleus ◽  
Microglial Activation ◽  
Healthy Aging ◽  
Cell Types ◽  
Norepinephrine System ◽  
Protective Processes ◽  
The Central Nervous System ◽  
Brain And Spinal Cord ◽  
The Brain

Abstract Background The role of microglia in Alzheimer’s disease (AD) pathogenesis is becoming increasingly important, as activation of these cell types likely contributes to both pathological and protective processes associated with all phases of the disease. During early AD pathogenesis, one of the first areas of degeneration is the locus coeruleus (LC), which provides broad innervation of the central nervous system and facilitates norepinephrine (NE) transmission. Though the LC-NE is likely to influence microglial dynamics, it is unclear how these systems change with AD compared to otherwise healthy aging. Methods In this study, we evaluated the dynamic changes of neuroinflammation and neurodegeneration in the LC-NE system in the brain and spinal cord of APP/PS1 mice and aged WT mice using immunofluorescence and ELISA. Results Our results demonstrated increased expression of inflammatory cytokines and microglial activation observed in the cortex, hippocampus, and spinal cord of APP/PS1 compared to WT mice. LC-NE neuron and fiber loss as well as reduced norepinephrine transporter (NET) expression was more evident in APP/PS1 mice, although NE levels were similar between 12-month-old APP/PS1 and WT mice. Notably, the degree of microglial activation, LC-NE nerve fiber loss, and NET reduction in the brain and spinal cord were more severe in 12-month-old APP/PS1 compared to 12- and 24-month-old WT mice. Conclusion These results suggest that elevated neuroinflammation and microglial activation in the brain and spinal cord of APP/PS1 mice correlate with significant degeneration of the LC-NE system.

Gastric Toxoplasmosis as the Presentation of Acquired Immunodeficiency Syndrome

2005 ◽  
Vol 129 (4) ◽  
pp. e87-e90 ◽  
Author(s):  
Mihai Merzianu ◽  
Steven M. Gorelick ◽  
Voltaire Paje ◽  
Donald P. Kotler ◽  
Corazon Sian
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
English Literature ◽  
Human Immunodeficiency Virus Status ◽  
Old West ◽  
Immunosuppressed Patients ◽  
The Central Nervous System ◽  
Acquired Immunodeficiency ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome ◽  
Disseminated Disease

Abstract We report a case of a 39-year-old West African man with unknown human immunodeficiency virus status diagnosed with gastric toxoplasmosis as the presenting manifestation of acquired immunodeficiency syndrome. Toxoplasma gondii is common in severely immunosuppressed patients and most frequently involves the central nervous system, followed by the eye, myocardium and skeletal muscle, lungs, bone marrow, and peripheral blood. For unclear reasons, gastrointestinal involvement is exceedingly rare and occurs in the context of severe immunosuppression and disseminated disease. To our knowledge, this is the first report in the English literature of a patient with isolated, manifest gastric toxoplasmosis without evidence of concomitant cerebral or extracerebral involvement. It is important for both the clinician and the pathologist to maintain a high index of suspicion for toxoplasmosis in immunosuppressed patients presenting with nonspecific symptoms of gastritis and radiologic and endoscopic presence of thickened gastric folds with or without ulceration.

scholarly journals Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

2011 ◽  
Vol 02 (01) ◽  
pp. 004-011 ◽  
Author(s):  
Aliasgar Moiyadi ◽  
Prakash Shetty
Keyword(s):  
Spinal Cord ◽  
Objective Assessment ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Frameless Stereotaxy ◽  
Spinal Cord Tumors ◽  
Individual Parameter ◽  
Objective Evidence ◽  
Intraoperative Localization ◽  
Brain And Spinal Cord

ABSTRACT Background: Localization and delineation of extent of lesions is critical for safe maximal resection of brain and spinal cord tumors. Frame-based and frameless stereotaxy and intraoperative MRI are costly and not freely available especially in economically constrained nations. Intraoperative ultrasound has been around for a while but has been relegated to the background. Lack of objective evidence for its usefulness and the perceived “user unfriendliness” of US are probably responsible for this. We recount our experience with this “forgotten” tool and propose an objective assessment score of its utility in an attempt to revive this practice. Materials and Methods: Seventy seven intraoperative ultrasound (IOUS) studies were carried out in patients with brain and spinal cord tumors. Seven parameters were identifi ed to measure the “utility” of the IOUS and a “utility score” was devised (minimum 0 and maximum 7). Individual parameter and overall scores were calculated for each case. Results: IOUS was found to be useful in many ways. The median overall score was 6 (mean score 5.65). There were no scores less than 4 with the majority demonstrating usefulness in 5 or more parameters (91%). The use of the IOUS signifi cantly infl uenced the performance of the surgery in these cases without signifi cantly prolonging surgery. Conclusions: The IOUS is a very useful tool in intraoperative localization and delineation of lesions and planning various stages of tumor resection. It is easy, convenient, reliable, widely available, and above all a cost-eff ective tool. It should be increasingly used by neurosurgeons in the developing world where costlier intraoperative localization and imaging is not available freely.

scholarly journals A Case Report of Acute Severe Myelitis and Meningitis Secondary to Varicella Zoster Virus Reactivation in a Patient with Acquired Immunodeficiency Syndrome

2021 ◽  
Author(s):  
Victor A Novelo-Hernández ◽  
Marco Cárdenas ◽  
Claudia Torres-González ◽  
Patricio Garcia-Espinosa ◽  
Rómulo Ramirez ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Varicella Zoster Virus ◽  
Acquired Immunodeficiency Syndrome ◽  
Clinical Manifestations ◽  
Virus Reactivation ◽  
Neck Stiffness ◽  
Varicella Zoster ◽  
Wide Range ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Background: Myelitis post Herpes-Zoster is a rare condition that is typically associated with immunocompromised states. It usually starts as an acute loss of sensory and motor functions below the affected spinal cord level. The condition can range in severity from a mild to a fatal presentation. Other neurological complications include meningitis, atypical presentations should encourage the search for undiagnosed immunosuppression states. The Case: We describe the case of a 42-year-old man, previously undiagnosed with HIV, who developed acute myelitis and meningitis after the appearance of the classic zoster lesions. On lumbar puncture and subsequent CSF analysis, the patient was found to have Froin’s Syndrome. The patient was initiated with ceftriaxone, vancomycin, and acyclovir regimen and prophylactic antiphymic treatment was also added. After 14 days in the hospital, the fever, headache, and neck stiffness subsided while the sphincter function and lower limb paraplegia did not improve.   Conclusion: Varicella zoster virus reactivation suggests underlying immunosuppression. This case demonstrates the importance of being cognizant to the wide range of clinical manifestations that may suggest spinal cord involvement after clinical reactivation. Furthermore, physicians also need to be mindful that Acquired Immunodeficiency Syndrome (AIDS) and other immunodeficiency states could present with atypical clinical manifestations.

Adenoid cystic carcinoma with a leptomeningeal dissemination in a ‘wash’ pattern

2021 ◽  
Vol 14 (12) ◽  
pp. e247155
Author(s):  
Juan Daniel Prieto Cuadra ◽  
Maria Teresa Dawid de Vera ◽  
Eva García Carrasco ◽  
M Isabel Hierro Martín
Keyword(s):  
Spinal Cord ◽  
Adenoid Cystic Carcinoma ◽  
Primary Tumour ◽  
Glucose Consumption ◽  
Leptomeningeal Dissemination ◽  
Adenoid Cystic ◽  
The Central Nervous System ◽  
Brain And Spinal Cord ◽  
Neurological State ◽  
Tuberculostatic Agents

A 39-year-old woman was referred to the neurology department due to headache, instability and difficulty walking for 5 months. Several ancillary tests were performed. The blood test showed leucocytosis and the cerebrospinal fluid revealed an increased total protein and glucose consumption. Other infections or autoimmune causes were excluded. The MRI showed non-specific brain and spinal cord lesions. Given the findings described, a differential diagnosis between granulomatous meningoencephalitis and primary tumour or metastasis was proposed. Empirical treatment with tuberculostatic agents and corticosteroids was started. The neurological state of the patient worsened, she fell into a non-responsive coma and died in few days. The clinical autopsy performed revealed an adenoid cystic carcinoma with involvement of the central nervous system that developed leptomeningeal dissemination along the spinal cord in a fluid ‘wash’ pattern.

METACHROMATIC LEUKO-ENCEPHALOPATHY

PEDIATRICS ◽  
1958 ◽  
Vol 22 (6) ◽  
pp. 1064-1073
Author(s):  
Raymond F. Hain ◽  
Gerald D. LaVeck
Keyword(s):  
Illustrative Case ◽  
Frozen Sections ◽  
Paraffin Sections ◽  
Mental Deterioration ◽  
Pathologic Findings ◽  
Blue Stain ◽  
The Central Nervous System ◽  
Metachromatic Granules ◽  
The Brain ◽  
Formalin Fixed

Metachromatic leuko-encephalopathy is a familial degenerative disease of the central nervous system included with Schilder's disease as a type of diffuse cerebral sclerosis. The disease usually has its onset early in childhood and is characteried by progressive motor and mental deterioration with ataxia, muscular weakness, spasticity, optic atrophy, convulsions and finally dementia. The concentration of protein of the cerebrospinal fluid is frequently elevated. The pathologic findings consist of demyelination, destruction of axons, gliosis and the accumulation of metachromatic granules in the brain and other organs. The metachromasia can be demonstrated in formalin-fixed frozen sections with a toluidine blue stain. It is not demonstrable in paraffin sections. Histochemical studies indicate this abnormal material is probably a complex of glycolipids and protein. It has been reported elsewhere that early diagnosis can be established by demonstrating the metachromatic materials in urinary sediment or in a real biopsy. An illustrative case has been presented.

scholarly journals Genomic Landscape of Intramedullary Spinal Cord Tumors Suggests Distinct Genetic Origins Compared to Intracranial Histopathologic Counterparts

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tej D Azad ◽  
Ming Zhang ◽  
Rajiv Iyer ◽  
Qing Wang ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Treatment Options ◽  
Driver Mutations ◽  
Whole Genome ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Molecular Features ◽  
The Central Nervous System

Abstract INTRODUCTION Intramedullary spinal cord tumors (IMSCTs) are a rare, heterogeneous group of neoplasms with limited treatment options and high rates of morbidity and mortality. Next-generation sequencing has revealed opportunities for targeted therapies of the intracranial counterparts of IMSCT, but little is known about the molecular features of IMSCT. METHODS To better understand the genetic basis of these tumors we performed whole exome sequencing on fifty-one IMSCT and matched germline DNA, including 29 ependymomas, 16 astrocytomas, 4 gangliogliomas,1hemangioblastoma, and 1 oligodendroglioma. Whole-genome sequencing was further performed on 12 IMSCT to discover possible structural variants. RESULTS Though recurrent somatic mutations in IMSCTs were rare, we identified NF2 mutations in 15.7% of tumors (ependymoma, N = 7; astrocytoma, N = 1), RP1 mutations in 5.9% of tumors (ependymoma, N = 3), and ESX1 mutations in 5.9% of tumors (ependymoma, N = 3). We further identified copy number amplifications in CTU1 in 25% of myxopapillary ependymomas. Given the paucity of somatic driver mutations, we further performed whole-genome sequencing of 12 tumors (ependymoma, N = 9; astrocytoma, N = 3). Overall, we observed that IMSCTs with intracranial histologic counterparts did not harbor the canonical mutations associated with their intracranial counterparts (eg glioblastoma). CONCLUSION Our findings suggest that the origin of IMSCTs may be distinct from tumors arising within other compartments of the central nervous system and provides a framework to begin more biologically based therapeutic strategies.

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