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The spectrum of microvascular patterns in adult diffuse glioma and their correlation with tumor grade
Soni , Vaishali Walke, Deepti Joshi, Tanya Sharma, Adesh Shrivastava, Amit Agrawal
J Pathol Transl Med. 2024;58(3):127-133.   Published online May 14, 2024
DOI: https://doi.org/10.4132/jptm.2024.03.11
  • 6,799 View
  • 348 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Primary brain tumors constitute the leading cause of cancer-related mortality. Among them, adult diffuse gliomas are the most common type, affecting the cerebral hemispheres and displaying a diffuse infiltrative pattern of growth in the surrounding neuropil that accounts for about 80% of all primary intracranial tumors. The hallmark feature of gliomas is blood vessel proliferation, which plays an important role in tumor growth, tumor biological behavior, and disease outcome. High-grade gliomas exhibit increased vascularity, the worst prognosis, and lower survival rates. Several angiogenic receptors and factors are upregulated in glioblastomas and stimulate angiogenesis signaling pathways by means of activating oncogenes and/or down-regulating tumor-suppressor genes. Existing literature has emphasized that different microvascular patterns (MVPs) are displayed in different subtypes of adult diffuse gliomas.
Methods
We examined the distribution and biological characteristics of different MVPs in 50 patients with adult diffuse gliomas. Haematoxylin and eosin staining results, along with periodic acid–Schiff and CD34 dual-stained sections, were examined to assess the vascular patterns and correlate with different grades of diffuse glioma.
Results
The present observational study on adult diffuse glioma evaluated tumor grade and MVPs. Microvascular sprouting was the most common pattern, while a bizarre pattern (type 2) was associated with the presence of a high-grade glioma. Vascular mimicry was observed in 6% of cases, all of which were grade 4 gliomas.
Conclusions
This study supplements the role of neo-angiogenesis and aberrant vasculature patterns in the grading and progression of adult diffuse gliomas, which can be future targets for planning treatment strategies.

Citations

Citations to this article as recorded by  
  • Unlocking therapeutic potential: Exploring nuclear receptors in brain cancer treatment
    Sujitha Jayaprakash, Hiu Yan Lam, Ravichandran Vishwa, Bandari BharathwajChetty, Kenneth C-H Yap, Mohammed S. Alqahtani, Mohamed Abbas, Gautam Sethi, Alan Prem Kumar, Ajaikumar B. Kunnumakkara
    Chinese Medical Journal.2025; 138(21): 2722.     CrossRef
  • Uptake patterns of Adult-type Non-Enhanced diffuse gliomas on [11C] methionine positron emission tomography
    Shoji Yasuda, Naoya Imai, Hirohito Yano, Yuka Ikegame, Soko Ikuta, Takashi Maruyama, Noriyuki Nakayama, Morio Kumagai, Yoshihiro Muragaki, Jun Shinoda, Tsuyoshi Izumo
    Neuroradiology.2025; 67(10): 2611.     CrossRef
  • Loss of Fibronectin Fiber Tension in Glioblastoma is Associated with Microvascular Proliferations and Immune Cell Infiltration
    Michele Crestani, Isabel Gerber, Arnaud Mieville, Katrin Frauenknecht, Theoni Maragkou, Tibor Hortobagyi, Viola Vogel
    Advanced Science.2025;[Epub]     CrossRef
  • High ORC6 expression is a prognostic indicator of poor survival in glioma patients
    Mengjie Wang, Song Feng, Chen Zhang, Feng Jin
    Scientific Reports.2025;[Epub]     CrossRef
  • Consequences of Hypoxic Events, Necrosis, and Microvascular Density, in Astrocytoma IDH-Mutant, CNS WHO Grade 4
    Cristian Ionut Orasanu, Madalina Bosoteanu, Sorin Vamesu, Raluca Ioana Voda, Anamaria Sincu, Mariana Deacu
    Medical Sciences.2025; 14(1): 6.     CrossRef
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The prognostic significance of p16 expression pattern in diffuse gliomas
Jin Woo Park, Jeongwan Kang, Ka Young Lim, Hyunhee Kim, Seong-Ik Kim, Jae Kyung Won, Chul-Kee Park, Sung-Hye Park
J Pathol Transl Med. 2021;55(2):102-111.   Published online December 23, 2020
DOI: https://doi.org/10.4132/jptm.2020.10.22
  • 9,813 View
  • 309 Download
  • 22 Web of Science
  • 19 Crossref
AbstractAbstract PDF
Background
CDKN2A is a tumor suppressor gene that encodes the cell cycle inhibitor protein p16. Homozygous deletion of the CDKN2A gene has been associated with shortened survival in isocitrate dehydrogenase (IDH)–mutant gliomas. This study aimed to analyze the prognostic value of p16 and to evaluate whether p16 immunohistochemical staining could be used as a prognostic marker to replace CDKN2A genotyping in diffuse gliomas.
Methods
p16 immunohistochemistry was performed on tissue microarrays of 326 diffuse gliomas with diagnoses that reflected IDH-mutations and 1p/19q codeletion status. The results were divided into three groups (negative, focal expression, overexpression) according to the presence and degree of p16 expression. Survival analysis was performed to assess the prognostic value of p16 expression.
Results
A loss of p16 expression predicted a significantly worse outcome in all glioma patients (n=326, p<.001), in the IDH-mutant glioma patients (n=103, p=.010), and in the IDH-mutant astrocytoma patients (n=73, p=.032). However, loss of p16 expression did not predict the outcome in the IDH-wildtype glioma patients (n=223, p=.121) or in the oligodendroglial tumor patients with the IDH-mutation and 1p/19q codeletion (n=30, p=.457). Multivariate analysis showed the association was still significant in the IDH-mutant glioma patients (p=.008; hazard ratio [HR], 2.637; 95% confidence interval [CI], 1.295 to 5.372) and in the IDH-mutant astrocytoma patients (p=.001; HR, 3.586; 95% CI, 1.649 to 7.801). Interestingly, patients who presented with tumors with p16 overexpression also had shorter survival times than did patients with tumors with p16 focal expression in the whole glioma (p< .001) and in IDH-mutant glioma groups. (p=.046).
Conclusions
This study suggests that detection of p16 expression by immunohistochemistry can be used as a useful surrogate test to predict prognosis, especially in IDH-mutant astrocytoma patients.

Citations

Citations to this article as recorded by  
  • A comparison of CDKN2A status in gliomas using different techniques: The loss of p16 as a surrogate marker
    Arnault Tauziède-Espariat, Audrey Rousseau, Laetitia Basset, Raphaël Saffroy, Ana Cavillon, Amélie Lusque, Lauren Hasty, Alice Métais, Yvan Nicaise, Emmanuelle Uro-Coste, Pascale Varlet, Pascale Varlet, Arnault Tauziède-Espariat
    Journal of Neuropathology & Experimental Neurology.2025; 84(10): 847.     CrossRef
  • Cell-Specific Vulnerability of Human Glioblastoma and Astrocytoma Cells to Mephedrone—An In Vitro Study
    Marta Marszalek-Grabska, Marta Kinga Lemieszek, Michal Chojnacki, Sylwia Winiarczyk, Joanna Jakubowicz-Gil, Barbara Zarzyka, Jarosław Pawelec, Jolanta H. Kotlinska, Wojciech Rzeski, Waldemar A. Turski
    Molecules.2025; 30(11): 2277.     CrossRef
  • Clinical value and mechanism of CDKN2A in clear cell renal cell carcinoma
    Yan Li, Songsong Wang, Yilong Lin, Junting Li, Xin Lan, Anqi Lv, Junwei Chen, Ziming Liu
    Discover Oncology.2025;[Epub]     CrossRef
  • Revealing the role of necroptosis microenvironment: FCGBP + tumor-associated macrophages drive primary liver cancer differentiation towards cHCC-CCA or iCCA
    Chun Wang, Cuimin Chen, Wenting Hu, Lili Tao, Jiakang Chen
    Apoptosis.2024; 29(3-4): 460.     CrossRef
  • FISH analysis reveals CDKN2A and IFNA14 co-deletion is heterogeneous and is a prominent feature of glioblastoma
    Sofian Al Shboul, Shelagh Boyle, Ashita Singh, Tareq Saleh, Moath Alrjoub, Ola Abu Al Karsaneh, Amel Mryyian, Rand Dawoud, Sinem Gul, Shaden Abu Baker, Kathryn Ball, Ted Hupp, Paul M. Brennan
    Brain Tumor Pathology.2024; 41(1): 4.     CrossRef
  • p16 Expression in Laryngeal Squamous Cell Carcinoma: A Surrogate or Independent Prognostic Marker?
    Roberto Gallus, Davide Rizzo, Giorgia Rossi, Luca Mureddu, Jacopo Galli, Alberto Artuso, Francesco Bussu
    Pathogens.2024; 13(2): 100.     CrossRef
  • CDKN2A/B deletion in IDH-mutant astrocytomas: An evaluation by Fluorescence in-situ hybridization
    Manali Ranade, Sridhar Epari, Omshree Shetty, Sandeep Dhanavade, Sheetal Chavan, Ayushi Sahay, Arpita Sahu, Prakash Shetty, Aliasgar Moiyadi, Vikash Singh, Archya Dasgupta, Abhishek Chatterjee, Sadhana Kannan, Tejpal Gupta
    Journal of Neuro-Oncology.2024; 167(1): 189.     CrossRef
  • Molecular prognostication in grade 3 meningiomas and p16/MTAP immunohistochemistry for predicting CDKN2A/B status
    Kira Tosefsky, Karina Chornenka Martin, Alexander D Rebchuk, Justin Z Wang, Farshad Nassiri, Amy Lum, Gelareh Zadeh, Serge Makarenko, Stephen Yip
    Neuro-Oncology Advances.2024;[Epub]     CrossRef
  • Insights into brain tumor diagnosis: exploring in situ hybridization techniques
    E. D. Namiot, G. M. Zembatov, P. P. Tregub
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • CDKN2A Homozygous Deletion Is a Stronger Predictor of Outcome than IDH1/2-Mutation in CNS WHO Grade 4 Gliomas
    Sang Hyuk Lee, Tae Gyu Kim, Kyeong Hwa Ryu, Seok Hyun Kim, Young Zoon Kim
    Biomedicines.2024; 12(10): 2256.     CrossRef
  • Homozygous CDKN2A/B deletions in low- and high-grade glioma: a meta-analysis of individual patient data and predictive values of p16 immunohistochemistry testing
    Darius Noack, Johannes Wach, Alonso Barrantes-Freer, Nils H. Nicolay, Erdem Güresir, Clemens Seidel
    Acta Neuropathologica Communications.2024;[Epub]     CrossRef
  • p16 Immunohistochemical Expression as a Surrogate Assessment of CDKN2A Alteration in Gliomas Leading to Prognostic Significances
    Lucas Geyer, Thibaut Wolf, Marie-Pierre Chenard, Helene Cebula, Roland Schott, Georges Noel, Eric Guerin, Erwan Pencreach, Damien Reita, Natacha Entz-Werlé, Benoît Lhermitte
    Cancers.2023; 15(5): 1512.     CrossRef
  • P16 immunohistochemistry is a sensitive and specific surrogate marker for CDKN2A homozygous deletion in gliomas
    Meenakshi Vij, Benjamin B. Cho, Raquel T. Yokoda, Omid Rashidipour, Melissa Umphlett, Timothy E. Richardson, Nadejda M. Tsankova
    Acta Neuropathologica Communications.2023;[Epub]     CrossRef
  • CDKN2A mutations have equivalent prognostic significance to homozygous deletion in IDH-mutant astrocytoma
    Raquel T Yokoda, William S Cobb, Raymund L Yong, John F Crary, Mariano S Viapiano, Jamie M Walker, Melissa Umphlett, Nadejda M Tsankova, Timothy E Richardson
    Journal of Neuropathology & Experimental Neurology.2023; 82(10): 845.     CrossRef
  • Efficient diagnosis of IDH-mutant gliomas: 1p/19qNET assesses 1p/19q codeletion status using weakly-supervised learning
    Gi Jeong Kim, Tonghyun Lee, Sangjeong Ahn, Youngjung Uh, Se Hoon Kim
    npj Precision Oncology.2023;[Epub]     CrossRef
  • The Prognostic Significance of P16 Immunohistochemical Expression Pattern in Women with Invasive Ductal Breast Carcinoma
    Alireza Rezaei, Navidreza Shayan, Saman Shirazinia, Sara Mollazadeh, Negin Ghiyasi-Moghaddam
    Reports of Biochemistry and Molecular Biology.2023; 12(1): 83.     CrossRef
  • Sporadic and Lynch syndrome-associated mismatch repair-deficient brain tumors
    Hyunhee Kim, Ka Young Lim, Jin Woo Park, Jeongwan Kang, Jae Kyung Won, Kwanghoon Lee, Yumi Shim, Chul-Kee Park, Seung-Ki Kim, Seung-Hong Choi, Tae Min Kim, Hongseok Yun, Sung-Hye Park
    Laboratory Investigation.2022; 102(2): 160.     CrossRef
  • Simple approach for the histomolecular diagnosis of central nervous system gliomas based on 2021 World Health Organization Classification
    Maher Kurdi, Rana H Moshref, Yousef Katib, Eyad Faizo, Ahmed A Najjar, Basem Bahakeem, Ahmed K Bamaga
    World Journal of Clinical Oncology.2022; 13(7): 567.     CrossRef
  • P16INK4A—More Than a Senescence Marker
    Hasan Safwan-Zaiter, Nicole Wagner, Kay-Dietrich Wagner
    Life.2022; 12(9): 1332.     CrossRef
Reclassification of Mongolian Diffuse Gliomas According to the Revised 2016 World Health Organization Central Nervous System Tumor Classification
Enkhee Ochirjav, Bayarmaa Enkhbat, Tuul Baldandorj, Gheeyoung Choe
J Pathol Transl Med. 2019;53(5):298-307.   Published online August 2, 2019
DOI: https://doi.org/10.4132/jptm.2019.07.15
  • 7,470 View
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AbstractAbstract PDF
Background
The 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors has been modified to incorporate the IDH mutation and 1p/19q co-deletion in the diagnosis of diffuse gliomas. In this study, we aimed to evaluate the feasibility and prognostic significance of the revised 2016 WHO classification of CNS tumors in Mongolian patients with diffuse gliomas.
Methods
A total of 124 cases of diffuse gliomas were collected, and tissue microarray blocks were made. IDH1 mutation was tested using immunohistochemistry, and 1p/19q co-deletion status was examined using fluorescence in situ hybridization analysis.
Results
According to the 2016 WHO classification, 124 cases of diffuse brain glioma were reclassified as follows: 10 oligodendroglioma, IDHmut and 1p/19q co-deleted; three anaplastic oligodendroglioma, IDHmut and 1p/19q co-deleted; 35 diffuse astrocytoma, IDHmut, 11 diffuse astrocytoma, IDHwt, not otherwise specified (NOS); 22 anaplastic astrocytoma, IDHmut, eight anaplastic astrocytoma, IDHwt, NOS; and 35 glioblastoma, IDHwt, NOS, respectively. The 2016 WHO classification presented better prognostic value for overall survival in patients with grade II tumors than traditional histological classification. Among patients with grade II tumors, those with oligodendroglioma IDHmut and 1p/19q co-deleted and diffuse astrocytoma IDHmut showed significantly higher survival than those with diffuse astrocytoma IDHwt, NOS (p<.01).
Conclusions
Mongolian diffuse gliomas could be reclassified according to the new 2016 WHO classification. Reclassification revealed substantial changes in diagnosis of both oligodendroglial and astrocytic entities. We have confirmed that the revised 2016 WHO CNS tumor classification has prognostic significance in Mongolian patients with diffuse gliomas, especially those with grade II tumors.

Citations

Citations to this article as recorded by  
  • Targeted next‐generation sequencing of adult gliomas for retrospective prognostic evaluation and up‐front diagnostics
    J. K. Petersen, H. B. Boldt, M. D. Sørensen, S. Blach, R. H. Dahlrot, S. Hansen, M. Burton, M. Thomassen, T. Kruse, F. R. Poulsen, L. Andreasen, H. Hager, B. P. Ulhøi, S. Lukacova, G. Reifenberger, B. W. Kristensen
    Neuropathology and Applied Neurobiology.2021; 47(1): 108.     CrossRef
Protein Phosphatase Magnesium-Dependent 1δ (PPM1D) Expression as a Prognostic Marker in Adult Supratentorial Diffuse Astrocytic and Oligodendroglial Tumors
Hui Jeong Jeong, Chang Gok Woo, Bora Lee, Shin Kwang Khang, Soo Jeong Nam, Jene Choi
J Pathol Transl Med. 2018;52(2):71-78.   Published online October 18, 2017
DOI: https://doi.org/10.4132/jptm.2017.10.21
  • 8,886 View
  • 201 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Protein phosphatase magnesium-dependent 1δ (PPM1D) is a p53-induced serine/ threonine phosphatase, which is overexpressed in various human cancers. A recent study reported that a mutation in the PPM1D gene is associated with poor prognosis in brainstem gliomas. In this study, we evaluated the utility of PPM1D as a prognostic biomarker of adult supratentorial diffuse astrocytic and oligodendroglial tumors.
Methods
To investigate PPM1D protein expression, mRNA expression, and copy number changes, immunohistochemistry, RNAscope in situ hybridization, and fluorescence in situ hybridization were performed in 84 adult supratentorial diffuse gliomas. We further analyzed clinical characteristics and overall survival (OS) according to PPM1D protein expression, and examined its correlation with other glioma biomarkers such as isocitrate dehydrogenase (IDH) mutation, and p53 expression.
Results
Forty-six cases (54.8%) were PPM1D-positive. PPM1D expression levels were significantly correlated with PPM1D transcript levels (p= .035), but marginally with PPM1D gene amplification (p=.079). Patients with high-grade gliomas showed a higher frequency of PPM1D expression than those with low-grade gliomas (p <.001). Multivariate analysis demonstrated that PPM1D expression (hazard ratio [HR], 2.58; p=.032), age over 60 years (HR, 2.55; p=.018), and IDH1 mutation (HR, 0.18; p=.002) were significantly independent prognostic factors; p53 expression had no prognostic significance (p=.986). The patients with tumor expressing PPM1D showed a shorter OS (p=.003). Moreover, patients with tumor harboring wild-type IDH1 and PPM1D expression had the worst OS (p<.001).
Conclusions
Our data suggest that a subset of gliomas express PPM1D; PPM1D expression is a significant marker of poor prognosis in adult supratentorial diffuse astrocytic and oligodendroglial tumors.

Citations

Citations to this article as recorded by  
  • Characteristic analysis and identification of novel molecular biomarkers in elderly glioblastoma patients using the 2021 WHO Classification of Central Nervous System Tumors
    Yaning Wang, Junlin Li, Yaning Cao, Wenlin Chen, Hao Xing, Xiaopeng Guo, Yixin Shi, Yuekun Wang, Tingyu Liang, Liguo Ye, Delin Liu, Tianrui Yang, Yu Wang, Wenbin Ma
    Frontiers in Neuroscience.2023;[Epub]     CrossRef
  • Metal-dependent Ser/Thr protein phosphatase PPM family: Evolution, structures, diseases and inhibitors
    Rui Kamada, Fuki Kudoh, Shogo Ito, Itsumi Tani, Jose Isagani B. Janairo, James G. Omichinski, Kazuyasu Sakaguchi
    Pharmacology & Therapeutics.2020; 215: 107622.     CrossRef
Reclassification of Mixed Oligoastrocytic Tumors Using a Genetically Integrated Diagnostic Approach
Seong-Ik Kim, Yujin Lee, Jae-Kyung Won, Chul-Kee Park, Seung Hong Choi, Sung-Hye Park
J Pathol Transl Med. 2018;52(1):28-36.   Published online September 29, 2017
DOI: https://doi.org/10.4132/jptm.2017.09.25
  • 9,665 View
  • 233 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Mixed gliomas, such as oligoastrocytomas (OA), anaplastic oligoastrocytomas, and glioblastomas (GBMs) with an oligodendroglial component (GBMO) are defined as tumors composed of a mixture of two distinct neoplastic cell types, astrocytic and oligodendroglial. Recently, mutations ATRX and TP53, and codeletion of 1p/19q are shown to be genetic hallmarks of astrocytic and oligodendroglial tumors, respectively. Subsequent molecular analyses of mixed gliomas preferred the reclassification to either oligodendroglioma or astrocytoma. This study was designed to apply genetically integrated diagnostic criteria to mixed gliomas and determine usefulness and prognostic value of new classification in Korean patients.
Methods
Fifty-eight cases of mixed OAs and GBMOs were retrieved from the pathology archives of Seoul National University Hospital from 2004 to 2015. Reclassification was performed according to genetic and immunohistochemical properties. Clinicopathological characteristics of each subgroup were evaluated. Overall survival was assessed and compared between subgroups.
Results
We could reclassify all mixed OAs and GBMOs into either astrocytic or oligodendroglial tumors. Notably, 29 GBMOs could be reclassified into 11 cases of GBM, IDH-mutant, 16 cases of GBM, IDH-wildtype, and two cases of anaplastic oligodendroglioma, IDH mutant. Overall survival was significantly different among these new groups (p<.001). Overall survival and progression-free survival were statistically better in gliomas with IDH mutation, ATRX mutation, no microscopic necrosis, and young patient age (cut off, 45 years old).
Conclusions
Our results strongly suggest that a genetically integrated diagnosis of glioma better reflects prognosis than former morphology-based methods.

Citations

Citations to this article as recorded by  
  • SNUH methylation classifier for CNS tumors
    Kwanghoon Lee, Jaemin Jeon, Jin Woo Park, Suwan Yu, Jae-Kyung Won, Kwangsoo Kim, Chul-Kee Park, Sung-Hye Park
    Clinical Epigenetics.2025;[Epub]     CrossRef
  • Oligodendrogliomas: findings after classifying the same cohort using pre- and post-World Health Organization (WHO) 2021 criteria
    Maria Angeles Vaz-Salgado, Juan M Sepulveda, Julie Earl, Jacqueline Gutierrez, Yolanda Ruano, Hector Pian, Diana Cantero, Aurelio Hernández-Lain
    Brain Communications.2025;[Epub]     CrossRef
  • The prognostic significance of p16 expression pattern in diffuse gliomas
    Jin Woo Park, Jeongwan Kang, Ka Young Lim, Hyunhee Kim, Seong-Ik Kim, Jae Kyung Won, Chul-Kee Park, Sung-Hye Park
    Journal of Pathology and Translational Medicine.2021; 55(2): 102.     CrossRef
  • Dynamic susceptibility contrast and diffusion MR imaging identify oligodendroglioma as defined by the 2016 WHO classification for brain tumors: histogram analysis approach
    Anna Latysheva, Kyrre Eeg Emblem, Petter Brandal, Einar Osland Vik-Mo, Jens Pahnke, Kjetil Røysland, John K. Hald, Andrés Server
    Neuroradiology.2019; 61(5): 545.     CrossRef
Case Studies
WHO Grade IV Gliofibroma: A Grading Label Denoting Malignancy for an Otherwise Commonly Misinterpreted Neoplasm
Paola A. Escalante Abril, Miguel Fdo. Salazar, Nubia L. López García, Mónica N. Madrazo Moya, Yadir U. Zamora Guerra, Yadira Gandhi Mata Mendoza, Erick Gómez Apo, Laura G. Chávez Macías
J Pathol Transl Med. 2015;49(4):325-330.   Published online June 17, 2015
DOI: https://doi.org/10.4132/jptm.2015.05.20
Correction in: J Pathol Transl Med 2015;49(6):538
  • 10,241 View
  • 78 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a 50-year-old woman with no relevant clinical history who presented with headache and loss of memory. Magnetic resonance imaging showed a left parieto-temporal mass with annular enhancement after contrast media administration, rendering a radiological diagnosis of high-grade astrocytic neoplasm. Tumour sampling was performed but the patient ultimately died as a result of disease. Microscopically, the lesion had areas of glioblastoma mixed with a benign mesenchymal constituent; the former showed hypercellularity, endothelial proliferation, high mitotic activity and necrosis, while the latter showed fascicles of long spindle cells surrounded by collagen and reticulin fibers. With approximately 40 previously reported cases, gliofibroma is a rare neoplasm defined as either glio-desmoplastic or glial/benign mesenchymal. As shown in our case, its prognosis is apparently determined by the degree of anaplasia of the glial component.

Citations

Citations to this article as recorded by  
  • Rare Pediatric Invasive Gliofibroma Has BRAFV600E Mutation and Transiently Responds to Targeted Therapy Before Progressive Clonal Evolution
    Kristiyana Kaneva, Kee Kiat Yeo, Debra Hawes, Jianling Ji, Jaclyn A. Biegel, Marvin D. Nelson, Stefan Bluml, Mark D. Krieger, Anat Erdreich-Epstein
    JCO Precision Oncology.2019; (3): 1.     CrossRef
Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review
Na Rae Kim, Soyi Lim, Juhyeon Jeong, Hyun Yee Cho
Korean J Pathol. 2013;47(6):587-591.   Published online December 24, 2013
DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.587
  • 9,552 View
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AbstractAbstract PDF

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

Citations

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  • Mimics of primary ovarian cancer and primary peritoneal carcinomatosis – A pictorial review
    B. Lawson, I. Rajendran, J. Smith, A. Shakur, V. Sadler, T.J. Sadler, H.C. Addley, S. Freeman
    Clinical Radiology.2024; 79(10): 736.     CrossRef
  • Ovarian Immature Teratoma With Nodal Gliomatosis: A Case Report and Literature Review
    Marwa Alna’irat, W. Glenn McCluggage, Maysa Al-Hussaini
    International Journal of Gynecological Pathology.2023; 42(6): 627.     CrossRef
  • Germ Cell Tumors of the Ovary: A Review
    Preetha Ramalingam
    Seminars in Diagnostic Pathology.2023; 40(1): 22.     CrossRef
  • Immature Teratoma with Gliomatosis Peritonei Arising in a Young Girl: Report of a Rare Case and Review of Literature
    Isheeta Ahuja, Ruchi Rathore, Neerja Bhatla, Sandeep R. Mathur
    Indian Journal of Gynecologic Oncology.2023;[Epub]     CrossRef
  • Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review
    Sijian Li, Na Su, Congwei Jia, Xinyue Zhang, Min Yin, Jiaxin Yang
    Current Oncology.2022; 29(9): 6364.     CrossRef
  • Extratesticular gliomatosis peritonei after mesenteric teratoma: a case report and literature review
    Jiaqiang Li, Shoulin Li, Dong Xiao, Jiaming Song, Jianxiong Mao, Jianchun Yin
    Journal of International Medical Research.2021;[Epub]     CrossRef
  • Germ Cell Tumors of the Female Genital Tract
    Elizabeth D. Euscher
    Surgical Pathology Clinics.2019; 12(2): 621.     CrossRef
  • Gliomatosis peritonei: a series of eight cases and review of the literature
    Dan Wang, Cong-wei Jia, Rui-e Feng, Hong-hui Shi, Juan Sun
    Journal of Ovarian Research.2016;[Epub]     CrossRef
Original Article
MGMT Gene Promoter Methylation Analysis by Pyrosequencing of Brain Tumour.
Young Zoon Kim, Young Jin Song, Ki Uk Kim, Dae Cheol Kim
Korean J Pathol. 2011;45(5):455-462.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.5.455
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AbstractAbstract PDF
BACKGROUND
The aim of this study was to determine whether pyrosequencing (PSQ) might be useful to achieve O6-methyl guanine methyltransferase (MGMT) promoter methylation using 1- to 13-year-old archival tissues as a clinical biomarker in routine practice.
METHODS
The study included 141 formalin-fixed paraffin-embedded (FFPE) glial tumors from the archives of the Pathology Department from 1997-2010.
RESULTS
The average percentage of methylation (MP) of the 141 cases was 14.0+/-16.8%, and methylated cases were 32.3+/-14.9%. The average MP of each year did not show a linear increasing or decreasing pattern according to the age of the FFPE block (p=0.771). The average MP of methylated glioblastomas was 35.8+/-14.7%, 31.8+/-15.5% for anaplastic astrocytomas, and 22.4+/-15.1% for astrocytoma. A tendency was observed toward an increasing pattern of average MP with World Health Organization (WHO) grade (p=0.063) in astrocytic tumors. A correlation was observed between average MP and WHO grade (p=0.038) and a bimodal distribution was observed between the methylated and unmethylated cases, using a 9% cut-off value (p<0.001).
CONCLUSIONS
The results showed that a quantitative approach for MGMT promoter methylation yielded a 100% success rate for FFPE tissues from archives. PSQ can be used in a retrospective trial, but the cut-off value and calculation method should be further validated.

Citations

Citations to this article as recorded by  
  • CDKN2A Homozygous Deletion Is a Stronger Predictor of Outcome than IDH1/2-Mutation in CNS WHO Grade 4 Gliomas
    Sang Hyuk Lee, Tae Gyu Kim, Kyeong Hwa Ryu, Seok Hyun Kim, Young Zoon Kim
    Biomedicines.2024; 12(10): 2256.     CrossRef
  • Immunohistochemical Classification of Primary and Secondary Glioblastomas
    Kyu Sang Lee, Gheeyoung Choe, Kyung Han Nam, An Na Seo, Sumi Yun, Kyung Ju Kim, Hwa Jin Cho, Sung Hye Park
    Korean Journal of Pathology.2013; 47(6): 541.     CrossRef
Case Reports
Composite Pheochromocytoma or Paraganglioma of Adrenal Gland: A Case Report with Immunohistochemical Studies and Electron Microscopic Examination.
Hyeyoon Chang, Hoiseon Jeong, Younghye Kim, Sung Hye Park, Aeree Kim
Korean J Pathol. 2011;45(3):306-310.
DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.306
  • 4,675 View
  • 38 Download
  • 1 Crossref
AbstractAbstract PDF
Composite pheochromocytoma or paraganglioma of the adrenal gland is a well-recognized, yet extremely rare tumor with only one case reported in Korea. We report a case of incidentally found composite pheochromocytoma and ganglioneuroma of the adrenal gland in a 44-year-old female composed of intermingled components of pheochromocytom, ganglioneuroma, and cells with intermediate features. On immunohistochemical staining, the pheochromocytoma component was positive for synaptophysin and chromogranin, but negative for S-100 protein. Staining for the S-100 protein revealed sustentacular cells which formed a peripheral coat around the "Zellballen" and Schwann cells. The Fontana-Masson stain defined neuromelanin granules of ganglion cells and the ganglion cells expressed neural markers such as neurofilament proteins. Ultrastructural findings revealed pheochromocytes with a round or ovoid nucleus and occasionally prominent nucleolus containing numerous adrenaline and noradrenaline granules.

Citations

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  • Bilateral pheochromocytoma with ganglioneuroma component associated with multiple neuroendocrine neoplasia type 2A: a case report
    Boubacar Efared, Gabrielle Atsame-Ebang, Soufiane Tahirou, Khalid Mazaz, Nawal Hammas, Hinde El Fatemi, Laila Chbani
    Journal of Medical Case Reports.2017;[Epub]     CrossRef
Jugulotympanic Paraganglioma, Mimicking a Vascular Tumor: A Brief Case Report.
Ji Youn Sung, Chang Il Cha, Yong Koo Park
Korean J Pathol. 2010;44(5):543-546.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.543
  • 3,579 View
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AbstractAbstract PDF
Jugulotympanic paragangliomas (JTPs) known as glomus tumors, are neoplasms of variable invasiveness that arise from the paraganglia situated around the jugular bulb or middle ear. We now report a rare case of JTP in an 18-year-old male. Preoperative diagnoses through external auditory canal biopsy and radiologic examination both failed. Even using a frozen section, an informative finding was not obtained because mostly granulation tissue was present along with associated squeezing artifacts. On permanent histologic examination, small cell nests between many ectatic small vessels and fibrotic stroma were seen, and those cells were positive for CD56, synaptophysin and chromogranin. Because JTPs are rare and have rather different histologic findings - higher vascularity, smaller and less uniform tumor cells than other paragangliomas - they are easy to misdiagnose. However, remembering those differences may help the physician avoid missing JTPs.
First Report of a Gangliocytic Paraganglioma Arising in a Tailgut Cyst.
Yosep Chong, Mee Yon Cho
Korean J Pathol. 2010;44(4):435-440.
DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.435
  • 4,345 View
  • 25 Download
  • 2 Crossref
AbstractAbstract PDF
Here we present the first report of a gangliocytic paraganglioma arising in a tailgut cyst; it occurred in a 56-year-old man. Tailgut cysts are uncommon congenital hamartomatous lesions that arise in the retrorectal presacral space in infants or adults. Benign or malignant tumors associated with tailgut cysts are rarely described; the most common tumors are adenocarcinomas and carcinoid tumors. A gangliocytic paraganglioma is a rare benign tumor that occurs nearly exclusively in the second portion of the duodenum. Rare cases have been reported at other locations, but a tailgut cyst has never been described. In our case, a resected 3.9 x 3.3 x 3 cm mass was composed predominantly of a solid yellow white neuroendocrine tumor within the area of a tailgut cyst. The neuroendocrine component of this tumor was different from previously described carcinoid tumors with respect to the histologic findings of neural differentiation as well as the intermixed typical gangliocytic features highlighted by immunohistochemical stains for S-100 protein and neurofilament. Although an intermixed area of the tailgut cyst and gangliocytic paraganglioma were found in some areas, the pathogenesis of this tumor remains to be elucidated.

Citations

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  • Diagnosis of Tailgut Cyst in Gynecologic Patients: Systematic Review of the Literature
    Polina Schwarzman, Salvatore Andrea Mastrolia, Yael Sciaky-Tamir, Joel Baron, Boaz Sheizaf, Giuseppe Trojano, Reli Hershkovitz
    Journal of Endometriosis and Pelvic Pain Disorders.2017; 9(3): 168.     CrossRef
  • Fine Needle Aspiration Cytology Diagnosis of Tailgut Cyst: A Rare Entity
    Farhan Asif Siddiqui, Rajan Chopra, Yusef Al-Marzooq
    Acta Cytologica.2014; 58(2): 217.     CrossRef
Nasal Cerebral Heterotopia-so called Nasal Glioma: A case report.
Tae Sook Kim, Je G Chi
Korean J Pathol. 1995;29(4):517-520.
  • 1,998 View
  • 18 Download
AbstractAbstract PDF
Encephalocele and nasal glioma are rare, benign congenital neuroectodennal tumors which result from a failure of embryologic sepearation of neuroectodermal and ectodemlal tissues. Nasal glioma should be differentiated from a true glioma, and from a primary encephalocele, which is a herniation of the cranial contents through a bony defect in the skull. For this reason, nasal cerebral heterotopia is a preferred term. We report an unusual case of a nasal mass that was histologically indistinguishable from nasal cerebral heterotopia but proved to be connected to the skull base by fibrotic cord. The patient was a 2 year old girl who had had a slow growing palpable mass in the left epicanthal area for three months.
Gliosarcoma with Components of Anaplastic Oligodendroglioma and Unclassifiable Spindle Cells: A Case Report.
Jung Woo Choi, Youngseok Lee, Jung Suk An, Nam Hee Won, Yong Gu Chung, Yang Seok Chae
Korean J Pathol. 2008;42(1):45-49.
  • 2,116 View
  • 19 Download
AbstractAbstract PDF
Gliosarcoma is a distinct disease entity that is characterized by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. The tumor in our case was a rare morphologic variant of gliosarcoma with components of anaplastic oligodendroglioma and unclassifiable spindle cells. Spindle cells showed CD34 and S-100 protein immunoreactivity, which was possibly related to peripheral nerve sheath differentiation. This unique feature has not been described previously and so this case expands the spectrum of possible divergent mesenchymal differentiation, and it lends support to pluripotential stem cells being the origin of this tumor.
Original Articles
Immunohistochemical Expression of Synaptophysin in Brain Tumors.
Byung Ha Choi, Shin Kwang Khang
Korean J Pathol. 2001;35(5):433-439.
  • 4,498 View
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AbstractAbstract PDF
BACKGROUND
Perikaryal or perikaryal surface immunostaining for synaptophysin has been posited to distinguish the neoplastic neuronal elements of gangliogliomas from entrapped non-neoplastic neurons in other gliomas of various types. However, recent studies revealed that perikaryal surface immunoreactivity can be seen in the neurons of normal human spinal cords and brains, as well as in the brain tissues around certain non-neuronal lesions. To access the validity of this criterion in the diagnosis of ganglion cell neoplasms, we evaluated patterns of immunostaining of synaptophysin in neuronal, glial and some non-neuroepithelial tumors.
METHODS
We selected 104 cases of gangliogliomas, gangliocytomas, central neurocytomas, dysembryoplastic neuroepithelial tumors, astrocytomas, oligodendrogliomas, glioblastomas, a pleomorphic xanthoastrocytoma, meningiomas, arterio-venous malformations, craniopharyngiomas, a foreign body granuloma, temporal lobe epilepsies, and autopsied brains. A representative block including the gray matter was identified for each case, and synaptophysin immunostaining was performed.
RESULTS
Perikaryal and perikaryal surface immunoreactivity for synaptophysin was observed in the neurons of various types of lesions. Percentage of perikaryal and perikaryal surface immunoreactivity of the gangliogliomas, glial tumors, and non-neuroepithelial lesions were 100%/93%, 80%/58% and 57%/26%, respectively.
CONCLUSIONS
Although synaptophysin positive neurons are found in the ganglioglioma, these patterns are clearly not pathognomonic for glioneuronal tumors.
Adequate Microsatellite Markers for 1p/19q Loss of Heterozygosity of Oligodendroglial Tumors in Korean Patients.
Se Hoon Kim, Hoguen Kim, Tai Seung Kim
Korean J Pathol. 2005;39(1):23-33.
  • 2,153 View
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AbstractAbstract PDF
BACKGROUND
It is well known that oligodendrogliomas can be divided into two groups according to the 1p/19q or 1p loss of heterozygosity (LOH) status because oligodendrogliomas with the 1p/19q LOH or the 1p LOH have a better prognosis and chemosensitivity. In this study, we investigated the adequate microsatellite markers for 1p/19q LOH of oligodendroglial tumors in Korean patients.
METHODS
We performed PCR that was based on the LOH test with the 1p (D1S508, D1S199, D1S2734, D1S186 & D1S312) and 19q (D19S219, D19S112, D19S412 & D19S596) microsatellite markers; these were the markers that were recommended by other researchers. We performed this PCR on microdissected paraffin embedded tissue blocks of 67 tumors from 56 cases.
RESULTS
The PCR based LOH analysis revealed that 3 microsatellite markers (D1S508, D1S2734 & D1S186) of 1p and 2 markers (D19S219 & D19S412) of 19q had higher heterozygosity scores than other markers. In addition, chromosomal LOH status using these selective markers showed a statistically significant difference of prognosis for oligodendroglial tumors.
CONCLUSIONS
We can suggest that the microsatellite markers with high heterozygosity scores (D1S508, D1S2734, D1S186, D19S219 and D19S412) would be adequate microsatellite markers for a PCR based LOH test of oligodendroglial tumors in Korean patients.
Optic Nerve Glioma with Neurofibromatosis.
Na Hye Myong, Seung Sook Lee, Yun Lim Shu, Je G Chi
Korean J Pathol. 1993;27(5):524-530.
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AbstractAbstract PDF
Optic nerve gliomas manifest either as a solitary form or a component of von Recklinghausen's neurofibromatosis. The reported incidence of coexistence with neurofibromatosis varies from 12% to 70%. Usually there are no significant cytological differences between the gliomas that accomapny the disease and those that are deemed to be solitary manifestations. The only possible difference between them is the apparently more common association, with the former, of extensive arachnoid hyperplasia and of a more florid local gliomatous infiltration into the leptomeninges, altogether resulting in perineural thickening. Our cases were 8 and 6 years old girls, respectively, presented with slowly progressive proptosis for 4 years and visual disturbance for 2.5 months. There were multiple cafe au lait spots on their trunks, and case 2 showed Lisch nodules in the iris. MRI of brain revealed unilateral optic nerve thickening with involvement of chiasm or multiple intracranial lesions. Resection of optic nerve tumor was performed. Microscopically, variable degree of tumorous change was seen. Most typically enlarged area was composed of intraneural and perineural portions surrounded by a layer of intact dura. Intraneural tumor revealed proliferation of elongated, spindle-shaped pilocytic astrocytes in intertrabecular spaces and distention of the pial septa with fibrovascular thickening. Another segment had areas with reactive gliosis. Perineural tissue was considerably thickened and, associated with proliferation of meningothelial cells and fibroblasts intermingled with astrocytes and Rosenthal fibers. There were increase of the optic nerve diameter and distention of the overlying dura. Foci of arachnoid cell hyperplasia were noted in both cases, although differed in degree. Immunohistochemically, the tumor cells expressed glial fibrillary acidic protein in intraneural and perineural portions particularly in case 2.
Case Reports
Primary Spinal Oncocytic Paraganglioma.
Ji Hye Lee, Seong Hwan Park, Duk Hyun Cho, Bum Woo Yeom, Jong Sang Choi, Chul Hwan Kim, Yeon Lim Suh
Korean J Pathol. 2001;35(6):561-564.
  • 2,093 View
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AbstractAbstract
Paraganglioma is a generic term applied to tumors of paraganglia, regardless of location, and composed largely of paraganglionic chief cells. It is a rare tumor, especially in the spinal region. When it appears in the craniospinal axis, it is restricted to the cauda equina or filum terminale, and less commonly, the spinal nerve root. We report a case of oncocytic paraganglioma in the spinal nerve root of 13-year-old girl. The tumor was located in intradural and extramedullary areas from the 12th thoracic to the 1st lumbar vertebra. Histologically, the tumor cells with abundant eosinophilic cytoplasms show diffuse compact clusters, which are surrounded by fibers in a reticulin stain, like a nested pattern. The nuclei are round to ovoid in shape with mild atypia. Immunohistochemically, the tumor cells are positive for synaptophysin, neuron-specific enolase and vimentin but are negative for cytokeratin, chromogranin and glial fibrillary acidic protein. Some cells are positive for S-100 protein. The MIB-1 labeling index is low. Ultrastructurally, dense core neurosecretory granules are not found but mitochondrias are commonly noted.
Paraganglioma of Cauda Equina.
Seok Jin Kang, Youn Soo Lee, Byung Kee Kim, Sang In Shim
Korean J Pathol. 1997;31(9):895-897.
  • 1,860 View
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AbstractAbstract PDF
This case report describes a paraganglioma of the cauda equina in a 37-year-old man, as documented by light microscopy and immunohistochemistry. The patient experienced low back pain of 3 years duration, with the recent onset of sciatic pain and altered sensation in the right leg. Magnetic resonance imaging of L4 vertebral level revealed an ovoid, solid mass in the cauda equina. The mass was measured 1.5 cm in the greatest diameter. The histologic appearance was characterized by organoid pattern with clusters of chief cells (zellballen). Immunohistochemically, tumor cells are positive for keratin, epithelial membrane antigen, vimentin, neuron specific enolase and chromogranin.
Chordoid Glioma: A Case Report.
Jang Hee Kim, Jae Ho Han, Chull Shim
Korean J Pathol. 2002;36(1):66-69.
  • 1,988 View
  • 13 Download
AbstractAbstract PDF
The chordoid glioma is a recently recognized rare neoplasm of the third ventricle and hypothalamus and, as the name implies, has a chordoid appearance. Using histological, immunohistochemical and ultrastructural studies, we report a case of a 32-year-old man with a chordoid glioma in the third ventricle. Magnetic resonance T1-weighted images of the brain with homogenous contrast enhancement revealed a well circumscribed, isointense mass occupying the third ventricle. Histologically, the tumor showed cords and clusters of epithelioid cells within a mucinous background along with lymphoplasmacytic infiltrate, and appeared to be reminiscent of a chordoma or chordoid meningioma. Immunohistochemically, the tumor cells were immunoreactive for glial fibrillary acidic protein, vimentin and CD34 but negative for epithelial membrane antigen. Ultrastructural study revealed round to spindle shaped cells with abundant cytoplasmic intermediate filaments and cytoplasmic zonation.
Fine Needle Aspiration Cytology of Retroperitoneal Paraganglioma with an Unusual Pattern: A Case Report.
Jean A Kim, Young Shin Kim, Chang Suk Kang, An Hi Lee, Byung Kee Kim, Sang In Shim, Sun Moo Kim
J Pathol Transl Med. 1994;5(1):74-78.
  • 1,884 View
  • 17 Download
AbstractAbstract PDF
A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features.
Paraganglioma of the Thyroid: A Case Report.
Jin Joo Baek, Youn Soo Lee, Chang Seok Kang, Sang In Sim, Kyo Young Lee
Korean J Pathol. 2008;42(6):401-404.
  • 2,168 View
  • 29 Download
AbstractAbstract PDF
Paragangliomas (PGs) of the thyroid are very rare tumors. Based on the medical literature, thyroid PGs invariably affected women and they were always thought to be benign, and they have always been mistaken for other more common lesions. We report here on the first case of PG of the thyroid in a 45-year-old man in Korea. Ultrasonographically, the tumor showed hypoechoic features. Microscopically, the tumor showed the typical zellballen pattern. The small to medium-sized tumor cells contained moderate amounts of finely granular eosinophilic cytoplasm and round to oval nuclei with fine chromatin. The tumor invaded the thyroid capsule and the extrathyroidal tissue with vascular and perineural invasion. Immunohistochemically, the tumor showed positivity for chromogranin, S-100 protein, CD56a, and synaptophysin and negativity for calcitonin, thyroglobulin, galectin-3, p53, CK19, and EMA. The Ki-67 labeling Index was 10%. We concluded that our case has a high potential of metastasis, and a close follow up would be important.
Original Articles
Expression of Trans forming Growth Factor-a and Proliferating Cell Nuclear Antigen in Human Gliomas.
Gyeong Sin Lee, Byung Hyun Kim, Bong Kwon Chun, Man Ha Huh
Korean J Pathol. 1994;28(2):149-153.
  • 1,826 View
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AbstractAbstract PDF
To evaluate the expression of transforming growth factor-alpha(TGF-alpha) and proliferating cell nuclear antigen(PCNA) and its relation to the differentiation of the tumors, immunohistochemical studies were performed in 49 human gliomas. Tumors were graded by a 3-grade-system; grade I=low grade glioma, grade Il=anaplastic glioma, grade III=glioblastoma multiforme. TGF-A and PCNA were predominantly expressed in malignant gliomas compared with benign gliomas. Malignant gliomas revealed 87% TGF-A reactivity, while benign gliomas revealed 26% TGF-A reactivity. The proliferation index with PCNA was 26%+/-7%(mean+/-standard deviation) in malignant gliomas and 5%?% in benign gliomas. A strong positive correlation between tumor grade and extent of TGF-A and PCNA expression was found(P<0.0001, Chi square and P<0.002, T-test). Synchronous expression of TGF-A and PCNA was observed in 16 cases(33%). The results of this study support the suggestion that the expression of TGF-A might be a useful prognostic indicator in human gliomas.
Gangliocytic Paraganglioma.
Joon Mee Kim, Suk Jin Choi, Lucia Kim, In Suh Park, Jee Young Han, Young Chae Chu, Hyung Gil Kim, Sun Geun Choi
Korean J Pathol. 2005;39(6):428-432.
  • 2,927 View
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AbstractAbstract PDF
Gangliocytic paraganglioma (GP) is a rare benign tumor that is usually seen in the duodenum. It shows unique histologic features that are composed of a carcinoid or paraganglioma-like appearance, ganglion cells, and Schwann cells. The common presenting symptoms are abdominal pain, gastrointestinal bleeding and obstruction. The lesion can sometimes be asymptomatic and they are discovered incidentally. We experienced a case of incidentally found GP in a 73 year-old-man who had a colon cancer with liver metastasis. During the preoperative workup, a submucosal tumor was found in the duodenal papilla. The frozen diagnosis of the duodenal mass was GP, which was confirmed by the permanent sections and immunohistochemical staining. Pathologists should be alert to recognize and diagnose this rare, but benign disease, especially in the patient suffering with gastrointestinal cancer.
Case Reports
Chordoid Glioma: A Report of Two Cases.
Eun Jung Park, Hyun Sik O, Min Cheol Lee
Korean J Pathol. 2002;36(5):357-361.
  • 2,039 View
  • 15 Download
AbstractAbstract PDF
Chordoid glioma mainly occurs in the third ventricle, pineal gland, hypothalamus, and suprasella. We report two cases of chordoid gliomas of the third ventricles in adult males. Histologically, the tumors consisted of cords and clusters of oval to polygonal epitheliod cells with abundant cytoplasm. The backgrounds of the tumor show mucinous and lymphoplasmacytic infiltrates. Immunohistochemically, the tumor cells were positive for glial fibrillary acidic protein and negative for epithelial membrane antigen, cytokeratin and neurofilament protein. Histopathologic diagnosis of chordoid glioma should be made judiciously by differentiating them from other chordoid or epithelial tumors of the central nervous system.
Hyalinizing Trabecular Adenoma of the Thyroid: A case report.
Hyun ee Yim, Chull Shim, Euy Young Soh
Korean J Pathol. 1998;32(3):226-230.
  • 2,140 View
  • 57 Download
AbstractAbstract PDF
We report a case of hyalinizing trabecular adenoma of the thyroid gland with its immunohistochemical and ultrastructural features. A 53 year-old euthyroid woman presented a well defined small cold nodule on a thyroid iodine scan. Microscopically, oval and elongated tumor cells were arranged in trabeculae, clusters and a "zellballen" pattern resembling paraganglioma with scattered follicles. Nuclear features were characterized by fine nuclear grooves, acidophilic intranuclear cytoplasmic inclusions and perinucleolar halos. Abundant extracellular eosinophilic fibrohyaline matrix resembling amyloid were also noted. Immunostaining of tumor cells was positive for thyroglobulin and negative for calcitonin. In addition, tumor cells displayed an unexpected, unique cytoplasmic immunoreactivity for MIB1. Electron microscopy revealed euchromatic nuclei with grooves, intranuclear cytoplasmic inclusions, intermediate filament stuffed cytoplasms and abundant extracellular basal lamina material.
Low-grade Immature Teratoma of the Ovary with Gliomatosis Peritonei: A case report.
Jin Young Yoo, Sang In Shim
Korean J Pathol. 1994;28(3):322-324.
  • 1,868 View
  • 10 Download
AbstractAbstract
Immature teratoma accounts for less than I percent of all ovarian teratomas and occurs commonly in young individuals, the peak incidence being in the second decade. It contains a variable mixture of mature and immature tissues in which neuroectodermal elements almost always predominate. Gliomatosis peritonei, miliary implants of mature glial tissues on the peritoneum or omentum, is an infrequently reported complication of mature or immature ovarian teratomas. We describe the first case in Korea of a 12-year-old girl with an immature teratoma and numerous glial peritoneal implants.
Brain Stem Glioma (An autopsy case).
Doo Hyun Chung, Soong Deok Lee, Hee Jin Yang, Dae Hee Han, Je G Chi
Korean J Pathol. 1991;25(6):607-610.
  • 1,928 View
  • 14 Download
AbstractAbstract PDF
We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.
Paraganglioma of the Urinary Bladder: A case report.
H K Lee, K M Lee, D K Chung
Korean J Pathol. 1988;22(2):164-168.
  • 1,935 View
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AbstractAbstract PDF
We herein report a case of paraganglioma arising from the urinary bladder in a 67-year-old woman. Her chief complaint was gross hematuria. However, she didn't manifest any other catecholamine-associated symptoms such as hypertension, palpitation and micturitional attack. Grossly, the tumor revealed bilobular external appearance with foci of ulceration and hemorrhage. The cut surface showed pinkish yellow homogeneous soft tissue. Microscopically, the tumor was composed of polygonal cells with basophilic granular plump cytocopic study, numerous membrane-bound electron dense granules were noted in the cytoplasm.
Paraganglioma of Cauda Equina: A case report.
Ji Hwa Kim, Sang Han Lee, Yoon Kyung Shon, Jyung Sik Kwak, Tae Joong Shon
Korean J Pathol. 1994;28(5):528-532.
  • 1,823 View
  • 13 Download
AbstractAbstract PDF
The clinical and pathological features of a paraganglioma arising in the cauda equina is described and compared with previous reports. The right microscopic fetures were similar to those of paragangliomas from other sites, with a 'Zellballen' pattern of cells containing arzyrophil granules. Immunohistocytochemical stains for neurone specific enolase, S-100 protein, cytokeratin were positive, but stains for glial fibrillary acidic protein were negative. Electron microscopy showed densely staining membrane-bound granules, cilia like structures and fibros bodies in the cytoplasm. The last two features only occur in paragangliomas from this site. The pathological findings suggest that paragangliomas in this site arise from pre-existing paraganglia, possibly of the visceral autonomic group.
Pigmented Mediastinal Paraganglioma: A case report.
Seong Ho Kim, Yoon Hee Jin, Eun Kyung Hong, Moon Hyang Park
Korean J Pathol. 2000;34(8):597-600.
  • 2,020 View
  • 34 Download
AbstractAbstract PDF
Pigmented extraadrenal paraganglioma is an unusual neoplasm that has rarely been reported in the literature. Based on histochemical staining or electron microscopy, pigment has been classified as lipofuscin, neuromelanin or true melanin. We report a case of pigmented extraadrenal paraganglioma in the posterior mediastinum of a 70-year-old woman. Histologically, the tumor had a characteristic organoid architecture of "zellballen" pattern with rich delicate microvasculature. Tumor cells contained numerous coarse brown-black pigment granules. Ultrastructurally, the tumor showed abundant large electron-dense pigment granules that vary in size and shape and smaller membrane-bound neurosecretory granules. The larger granules were consistent with neuromelanin or lipofuscin. Histochemically, the pigment is most likely neuromelanin, which is a waste product of catecholamine metabolism.
Original Articles
Synergistic Apoptotic Effect of Combination Treatment with Troglitazone and COX-2 Inhibitor in Glioma Cells.
Kyung Ryoul Kim, Min Young Park, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang
Korean J Pathol. 2007;41(1):1-6.
  • 2,121 View
  • 25 Download
AbstractAbstract PDF
BACKGROUND
The use of troglitazone (a PPARgamma ligand) and COX-2 inhibitor have been intensively studied for inhibition of tumor growth in cancer treatment, but the anti-tumor effect with a combination of these agents for cancer has not yet been studied. The aim of this study was to determine if low concentrations of troglitazone with COX-2 inhibitor in combination would cause significant cytotoxicity in glioma cells.
METHODS
The effects of co-treatment with troglitazone and COX-2 inhibitor on cell growth and apoptosis were assessed by use of trypan blue exclusion and a DNA fragmentation assay. A western blot was used to analyze the apoptotic signaling for the expression of bcl-2, bax, PARP and p21 proteins.
RESULTS
A low dose of troglitazone (5micrometer) and COX-2 inhibitor (5micrometer) strongly enhanced the cell growth inhibition and apoptosis in glioma cells when compared to a low dose of each drug alone. Western blotting analysis showed a decreased expression of bcl-2 and PARP proteins. In contrast, the bax protein level was increased.
CONCLUSIONS
The combination of troglitazone and COX-2 inhibitor in a low dose elicits synergistic cytotoxicity in glioma cells. Our study also demonstrates that down regulation of bcl-2, fragmentation of PARP protein and increased expression of bax protein were accompanied by co-treatment with troglitazone and the COX-2 inhibitor.
PPARgamma Ligand-Induced Decrease of in vivo Tumor Growth Accompanied by Increased Cytolytic Activity of Splenocytes.
Kyu Yun Jang, Ki Hoon Yu, Hak Yong Lee, Kyung Ryoul Kim, Ha Na Choi, Eun Jung Cha, Ho Sung Park, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee
Korean J Pathol. 2007;41(1):7-14.
  • 1,973 View
  • 23 Download
AbstractAbstract PDF
BACKGROUND
Recent studies have proposed the use of peroxisome proliferator activated receptor-gamma (PPARgamma) ligands as new chemotherapeutic agents for human malignant tumors. However the in vivo mechanism of PPARgamma ligands on cellular toxicity is not clear. Therefore we examined the anti-tumor effects of the PPARgamma ligand, rosiglitazone (ROS), in animal models.
METHODS
To evaluate the effect of RSO on splenocytes, an in vitro and in vivo study was performed. Cytolytic activity was measured by use of a 51Cr release assay. The splenic natural killer (NK) cell population and effector-target conjugation were measured by flow cytometric analysis.
RESULTS
In 9L glioma bearing rats, 30 mg/kg/d of ROS treatment induced a significant decrease of subcutaneous tumor growth accompanied by an increased cytolytic activity of splenocytes and of the splenic NKR-P1bright/CD3- NK cell population. In normal rats, systemic administration of ROS also increased the cytolytic activity of splenocytes, the splenic NK cell population, and effector-target conjugation. Moreover, we found that a concentration of 20micrometer ROS caused an increase in the cytolytic activity of splenocytes, and a concentration of 50micrometer ROS increased effector-target conjugation in vitro.
CONCLUSIONS
These results suggest that increased splenic cytolytic activity and NK cell population may contribute to the anti-tumor effects of PPARgamma ligands in vivo. However, the roles of NK cells in the PPARgamma ligand-induced anti-tumor activity should be further investigated.
Case Report
Heterotopic Brain Tissue in the Soft Palate.
Hyun Joo Choi, Youn Soo Lee, Young Shin Kim, Kyo Young Kim, Chang Suk Kang, Sang In Shim
Korean J Pathol. 1998;32(11):1039-1041.
  • 2,224 View
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AbstractAbstract
Heterotopic brain tissue is a developmental anomaly of neurogenic origin with no malignant potential, and is usually present around the nose of children and infants. So it has been called nasal glioma. But, even more rarely, heterotopic glial tissue may be found in various sites other than nasal cavity, such as the ethmoidal sinus, palate, tonsillar area, pharynx, ear, subcutaneous tissue, lung, and female genital tract. We experienced a more unusual case of a polypoid heterotopic brain tissue in the soft palate in a 3-year-old boy. The mass was microscopically reminiscent of "gliosis" of the central nervous system and interestingly contained choroid plexus focally. The glial nature of the lesion was confirmed by glial fibrillary acidic protein immunostain.

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