Retinoblastoma Morphology after Local Chemotherapy

Purpose. Determine the nature of tumor regression and possible complications associated with the retinotoxic effect of melphalan and carboplatin with local chemotherapy.Methods. A histological analysis of 19 enucleated eyes from 19 patients with retinoblastoma was performed after combined organ-preserving treatment, including systemic chemotherapy and local chemotherapy in various doses. The enucleated eyes were fixed in 10 % formalin and processed routinely for histological examination.Results. Significant changes in the tumor tissue such as tumor regression associated with the destruction of the tumor tissue and its replacement with fibrous tissue, glia proliferation, and the formation of petrificates were revealed. Complete regression of the tumor was detected in 3 out of 19 eyes, partial in 13 eyes. There were no signs of regression in 3 eyes. Tumor invasion into the choroid was found in 5 cases, into the anterior sector — in 3 cases, into the optic nerve — in 3 cases. The retrobulbar tumor was presented in 1 case. Retinotoxic complications revealed. Hemorrhagic changes associated with focal necrosis of the central retinal vessels (n = 4), destructive changes in retinal pigment epithelium (RPE; n = 10) associated with the accumulation of melphalan in RPE leading to atrophic processes in the retina. Complications in the form of secondary glaucoma, severe fibrosis and retinal detachment, despite the complete resorption of the tumor, led not only to loss of vision, but also hindered visualization of the fundus and substantiated the need for enucleation in 3 cases. In other cases, enucleation was performed due to continued tumor growth (n = 16) or progression during treatment (n = 3).Conclusions. Retinoblastoma can be controlled with local chemotherapy. However, clinical and morphological examinations of enucleated eyes revealed and confirmed, along with tumor resorption, intraocular complications as a result of the toxic effect of the drugs and the presence of active tumor tissue to varying degrees of therapeutic pathomorphism, which can be explained by the resistance of RB to these drugs. Thus, a further search is needed for drugs that destroy the tumor and minimize the retinotoxic effect.

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Microscopic Observation of Proliferative Membranes in Fibrocontractive Retinal Disorders

Journal of Ophthalmology ◽

10.1155/2019/9647947 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Rino Frisina ◽

Francesco Tessarolo ◽

Ivan Marchesoni ◽

Federico Piccoli ◽

Emiliana Bonomi ◽

...

Keyword(s):

Smooth Muscle Actin ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Fibrous Tissue ◽

Morphological Characteristics ◽

Repair Process ◽

Polymorphonuclear Cells ◽

Cell Nuclei ◽

Alpha Smooth Muscle Actin ◽

Retinal Disorders

Proliferative membranes of fibrocontractive retinal disorders are extensively studied from the morphological and evolutive point of view. Despite this, little is known of their cellular composition. In this study, the authors investigated the morphological characteristics and cell composition of various types of surgically excised proliferative membranes and internal limiting membranes (ILMs), in order to provide new data supporting or challenging the pathogenic theories proposed until now. Sixty-nine specimens from 64 eyes of 64 consecutive patients were collected at surgery and subjected to a multilevel analysis by means of optical and electron microscopy. Membrane samples were semiquantitatively evaluated for the amount and distribution of cell nuclei and pigment. Immunohistochemical staining was performed with antibodies to alpha smooth muscle actin and CD68. Data were analyzed after grouping according to the following tissue types: ILM (20 specimens), epiretinal membrane (ERM) (22 specimens), ILM + ERM (20 specimens), and proliferative vitreoretinopathy (PVR) (7 specimens). The cell components found in the ERM specimens, like myofibroblasts, macrophages, and polymorphonuclear cells, were recognized as the expression of cell migration and differentiation that induced an inflammatory process and a fibroproliferative repair process. The detection of pigments in specific types of ERM, like those associated with lamellar macular hole (LMH) or secondary to retinal detachment (RD), diabetes, and PVR, suggested that retinal pigment epithelium (RPE) cells may have a role in the development of these vitreoretinal disorders. The reduction of the ERM cellularity with the patient’s age supports the hypothesis that ERM evolves in time up to a fibrous tissue formation.

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Spontaneous Regression of Advanced Hepatocellular Carcinoma

Case Reports in Gastroenterology ◽

10.1159/000508847 ◽

2020 ◽

Vol 14 (3) ◽

pp. 491-496

Author(s):

Dhiraj J. Sonbare ◽

Rupal Bandi ◽

Vivek Sharma ◽

Thomas Cacciarelli ◽

Obaid S. Shaikh

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Invasion ◽

Spontaneous Regression ◽

Tumor Regression ◽

Complete Regression ◽

Advanced Hepatocellular Carcinoma ◽

Specific Therapy ◽

Therapeutic Implications ◽

Spontaneous Tumor Regression ◽

Related Mortality

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. The tumor carries poor prognosis with curative therapeutic options limited to surgical resection, tumor ablation, and liver transplantation. Rarely, there is spontaneous regression of the tumor. We describe the case of a 74-year-old male with cirrhosis from non-alcoholic steatohepatitis who developed advanced HCC that was associated with tumor invasion of the portal vein and marked elevation of serum alfa-fetoprotein level. The patient received no cancer-specific therapy. However, 1 year after the initial diagnosis, he was noted to have complete regression of the tumor. In this report, we discuss possible mechanisms of spontaneous tumor regression and its therapeutic implications.

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The Study Drug Pathomorphism And Immunohistochemical Parameters Of Tumor In Endoarterial Of Regional Long-Term Chemotherapy In Treatment Of Cervical Cancer

European Medical Health and Pharmaceutical Journal ◽

10.12955/emhpj.v1i0.331 ◽

2010 ◽

Vol 1 ◽

Author(s):

V Navruzova ◽

N Yuldasheva

Keyword(s):

Cervical Cancer ◽

Lymph Nodes ◽

Tumor Invasion ◽

Tumor Regression ◽

Locally Advanced ◽

Study Drug ◽

Complete Regression ◽

Regional Lymph Nodes ◽

Results Of Treatment

Background: To improve the results of radiotherapy for cervical cancer used local and systemic radio-modification drugs.Materials and methods: 1984 patients with locally advanced cervical cancer (2b - 3a stage), which at one stage of complex treatment by a course indo-arterial of regional long-term poly-chemotherapy (EARDPHT) mode: methotrexate - 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin - 100 mg/m2, for 48 hours, 2 stage - surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim - Meigs).Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 - year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume – 78.5%, with stabilization of tumor - no more than 58.4%.Conclusion: The study of molecular-biological parameters of the tumor cells show the effectiveness of conducted neo-advent indo-arterial chemotherapy and play an important role in further treatment and prediction of disease.

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Choroidal Melanoma Simulating Adenoma of the Retinal Pigment Epithelium Arising at the Site of Congenital Hypertrophy of the Retinal Pigment Epithelium

Ocular Oncology and Pathology ◽

10.1159/000501084 ◽

2019 ◽

Vol 6 (1) ◽

pp. 39-43 ◽

Cited By ~ 2

Author(s):

Basil K. Williams Jr. ◽

Maura Di Nicola ◽

J. Antonio Lucio-Alvarez ◽

David R. Lally ◽

Carol L. Shields

Keyword(s):

Retinal Pigment Epithelium ◽

Tumor Regression ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Serous Retinal Detachment ◽

Choroidal Melanoma ◽

Needle Aspiration ◽

Pigmented Lesion ◽

Imaging Characteristics ◽

Congenital Hypertrophy

Neoplasms of the retinal pigment epithelium (RPE) are rare tumors that can simulate choroidal melanoma, but clinical and imaging characteristics often differentiate these lesions. We report a 70-year-old male with an abruptly elevated pigmented lesion that arose at the site of congenital hypertrophy of the RPE and demonstrated associated exudation, as well as feeding and draining vessels, suggestive of RPE adenoma. Optical coherence tomography showed retinal elevation with serous retinal detachment adjacent to the mass, and ultrasonography revealed an abruptly elevated, moderately echodense mass of 6.4-mm thickness. Fluorescein angiography showed early tumor hypofluorescence, late tumor hyperfluorescence with staining and leakage, and retinal vessels buried under the mass, suggestive of a retinal tumor. The patient was monitored with the presumed diagnosis of RPE adenoma, but 3 months later, the growth was documented and fine-needle aspiration biopsy revealed choroidal melanoma. Management with I-125 plaque radiotherapy was performed leading to tumor regression and a thickness of 4.6 mm.

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Histology of neovascular myopic macular degeneration

Scientific Reports ◽

10.1038/s41598-021-01500-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shefali B. Jonas ◽

Songhomitra Panda-Jonas ◽

Jost B. Jonas ◽

Rahul A. Jonas

Keyword(s):

Macular Degeneration ◽

Axial Length ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Periodic Acid ◽

Fibrous Tissue ◽

Posterior Pole ◽

Rpe Cells ◽

Binary Regression Analysis ◽

Human Eyes

AbstractTo assess the histological correlate of neovascular or exudative myopic macular degeneration (nMMD) in highly myopic human eyes, we examined histomorphometrically histologic sections of enucleated eyes of Caucasian patients. The study included 284 eyes (age: 61.9 ± 13.7 years; range: 24–89 years; axial length: 25.5 ± 3.1 mm; range: 20–37 mm). An nMMD was detected in 5 eyes (axial length: 29.6 ± 2.6 mm; range: 26.0–31.0 mm). All these eyes showed within or close to the nMMD a macular Bruch’s membrane (BM) defect, fibrous tissue with erythrocyte-filled blood vessels, and proliferations of irregularly pigmented and irregularly piled-up retinal pigment epithelium (RPE) cells each of which was connected with a curled-up, PAS (Periodic-Acid-Shiff)-positive membrane. The nMMD lesions were covered by proliferated RPE cells. RPE cells were not detected within the retina. In binary regression analysis, a higher nMMD prevalence was associated with a higher prevalence of macular BM defects (odds ratio: > 1000; P < 0.001), while the association with axial length was not significant (P = 0.43) in that model. After adjustment for the presence of macular BM defects, the nMMD prevalence was not associated with BM thickness (measured at the posterior pole, equator-posterior pole midpoint, equator and shortly posterior to the ora serrata) (P = 0.10; P = 0.87; P = 0.40; and P = 0.36, respectively), RPE cell layer thickness (P = 0.83; P = 0.79; P = 0.31; P = 0.38, resp.), RPE cell density (P = 0.56; P = 0.91; P = 0.47; P = 0.87, resp.), choriocapillaris thickness (P = 0.47; P = 0.93; P = 0.41; P = 0.75, resp.), and choriocapillaris density (P = 0.99; P = 0.94; P = 0.17; P = 0.97, resp.). The results suggest that nMMD is characterized by a fibrous pseudo-metaplasia of the RPE and is strongly associated with macular BM defects, without other detected histomorphometric differences in thickness or density of the RPE, BM, and choriocapillaris.

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High-resolution scanning electron microscopy (HRSEM) of mitochondria from various rat tissues

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100102158 ◽

1988 ◽

Vol 46 ◽

pp. 14-15

Author(s):

P.J. Lea ◽

M.J. Hollenberg

Keyword(s):

Electron Microscopy ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Rat Hepatocytes ◽

Three Dimensions ◽

Objective Lens ◽

Rat Tissues ◽

Thin Sections ◽

Reconstruction Methods ◽

Scanning Electron

Our current understanding of mitochondrial ultrastructure has been derived primarily from thin sections using transmission electron microscopy (TEM). This information has been extrapolated into three dimensions by artist's impressions (1) or serial sectioning techniques in combination with computer processing (2). The resolution of serial reconstruction methods is limited by section thickness whereas artist's impressions have obvious disadvantages.In contrast, the new techniques of HRSEM used in this study (3) offer the opportunity to view simultaneously both the internal and external structure of mitochondria directly in three dimensions and in detail.The tridimensional ultrastructure of mitochondria from rat hepatocytes, retinal (retinal pigment epithelium), renal (proximal convoluted tubule) and adrenal cortex cells were studied by HRSEM. The specimens were prepared by aldehyde-osmium fixation in combination with freeze cleavage followed by partial extraction of cytosol with a weak solution of osmium tetroxide (4). The specimens were examined with a Hitachi S-570 scanning electron microscope, resolution better than 30 nm, where the secondary electron detector is located in the column directly above the specimen inserted within the objective lens.

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Ultrastructural Changes of Smoooth Endoplasmic Reticulum in the Retinal Pigment Epithelium by Choline Chloride

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100093547 ◽

1972 ◽

Vol 30 ◽

pp. 58-59

Author(s):

Kazushige Hirosawa ◽

Eichi Yamada

Keyword(s):

Endoplasmic Reticulum ◽

Epithelial Cell ◽

Smooth Endoplasmic Reticulum ◽

Pigment Epithelium ◽

Choline Chloride ◽

Retinal Pigment ◽

Ultrastructural Changes ◽

Lower Vertebrate ◽

Visual Cells ◽

Pigment Epithelial

The pigment epithelium is located between the choriocapillary and the visual cells. The pigment epithelial cell is characterized by a large amount of the smooth endoplasmic reticulum (SER) in its cytoplasm. In addition, the pigment epithelial cell of some lower vertebrate has myeloid body as a specialized form of the SER. Generally, SER is supposed to work in the lipid metabolism. However, the functions of abundant SER and myeloid body in the pigment epithelial cell are still in question. This paper reports an attempt, to depict the functions of these organelles in the frog retina by administering one of phospholipid precursors.

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High-voltage electron microscopy of subretinal scar formation

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100122836 ◽

1992 ◽

Vol 50 (1) ◽

pp. 486-487

Author(s):

G.E. Korte ◽

M. Marko ◽

G. Hageman

Keyword(s):

Electron Microscopy ◽

Monoclonal Antibody ◽

Retinal Pigment Epithelium ◽

Glial Cells ◽

High Voltage ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Sodium Iodate ◽

High Voltage Electron Microscopy ◽

Voltage Electron

Sodium iodate iv. damages the retinal pigment epithelium (RPE) in rabbits. Where RPE does not regenerate (e.g., 1,2) Muller glial cells (MC) forma subretinal scar that replaces RPE. The MC response was studied by HVEM in 3D computer reconstructions of serial thick sections, made using the STEREC0N program (3), and the HVEM at the NYS Dept. of Health in Albany, NY. Tissue was processed for HVEM or immunofluorescence localization of a monoclonal antibody recognizing MG microvilli (4).

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The photoreceptor cytoskeleton visualized

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100122800 ◽

1992 ◽

Vol 50 (1) ◽

pp. 480-481

Author(s):

Beth Burnside

Keyword(s):

Outer Segment ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Cell Polarization ◽

Synaptic Proteins ◽

Cell Functions ◽

Vertebrate Photoreceptor ◽

Numerous Cell ◽

Turn Over

The vertebrate photoreceptor provides a drammatic example of cell polarization. Specialized to carry out phototransduction at its distal end and to synapse with retinal interneurons at its proximal end, this long slender cell has a uniquely polarized morphology which is reflected in a similarly polarized cytoskeleton. Membranes bearing photopigment are localized in the outer segment, a modified sensory cilium. Sodium pumps which maintain the dark current critical to photosensory transduction are anchored along the inner segment plasma membrane between the outer segment and the nucleus.Proximal to the nucleus is a slender axon terminating in specialized invaginating synapses with other neurons of the retina. Though photoreceptor diameter is only 3-8u, its length from the tip of the outer segment to the synapse may be as great as 200μ. This peculiar linear cell morphology poses special logistical problems and has evoked interesting solutions for numerous cell functions. For example, the outer segment membranes turn over by means of a unique mechanism in which new disks are continuously added at the proximal base of the outer segment, while effete disks are discarded at the tip and phagocytosed by the retinal pigment epithelium. Outer segment proteins are synthesized in the Golgi near the nucleus and must be transported north through the inner segment to their sites of assembly into the outer segment, while synaptic proteins must be transported south through the axon to the synapse.The role of the cytoskeleton in photoreceptor motile processes is being intensely investigated in several laboratories.

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