Third ventricular primary cerebral neuroblastoma. Electron-microscopic and immunohistochemical study

A case of third ventricular primary cerebral neuroblastoma with secondary hydrocephalus is reported. Light microscopy showed a cell pattern that resembled either ependymoma or oligodendroglioma. The tumor was confirmed to be neuroblastoma by electron microscopy and immunohistochemistry. Immunoperoxidase staining was positive for neuron-specific enolase and negative for glial fibrillary acidic protein.     

A case of primary cerebral neuroblastoma surviving for eight years]

We report a case of a patient with primary cerebral neuroblastoma who has survived for 8 years. A 10-year-old boy was admitted to our hospital because of headache and nausea. CT scan on admission revealed a large cystic tumor on the right frontal lobe. Subtotal tumor resection was carried out. A second operation was performed for the residual tumors which were removed meticulously with confirmation of the absence of tumor cells on each frozen section. After tumor removal, YAG laser was applied at each local area. Histological diagnosis disclosed primary cerebral neuroblastoma. Because of postsurgical meningitis and parent's refusal, neither chemotherapy nor radiation therapy was performed. There have been no findings of the tumor recurrence during the last eight years, and now the patient is enjoying high school life to the full, without any neurological deficits. In reviewing the literature, outcomes of neuroblastoma cases are very poor. Our case seems to be one of the rare long-survival cases.     

Epithelial cells in a so-called intraspinal neurenteric cyst: A light and electron microscopic study

A case of so-called intraspinal neurenteric cyst is described. A single epithelial cyst, associated with a dimple in the sacral region, was located ventral to the spinal cord in the lower cervical region. On light microscopy, a single epithelial layer lining the cyst wall contained a few ciliated cells and squamous cells, in addition to many goblet cells. An electron microscopic study also demonstrated three different kind of cells. The goblet cells contained many secretory granules, the ciliated cells had many cilia, and the squamous cells were characterized by abundant tonofilaments and desmosomes.     

Morphology of lysolecithin-induced damage on esophageal mucosa. An experimental light and scanning electron microscopical study

The morphology of the esophageal mucosal damage induced by lysolecithin was investigated in an experimental model, where an isolated segment of rabbit esophagus was purfused in situ with lysolecithin, alone or in combination with HCl. The results indicate that lysolecithin alone causes no morphological damage to the esophageal mucosa. However, when combined with HCl, lysolecithin causes widening of intercellular spaces and detachment of superficial cells leading ultimately to disclosure of denuded submucosal collagen bundles. This suggests that, in clinical situations lysolecithin refluxed from the duodenum into the stomach and further to esophagus may have importance in the pathogenesis of reflux esophagitis when gastric acid is present, too. In contrast, under unacidic conditions (i.e., in the pathogenesis of alkaline reflux esophagitis) lysolecithin seems to be of minor importance.     

Liver hilus dearterialization. A histological and electron microscopical study in the dog.

Liver histological and electron microscopical changes were studied in six dogs after liver hilus dearterialization and in two dogs after sham operation. All specimens were taken in vivo. In light microscopy a marked dilatation of the sinusoids was noted 90 minutes after dearterialization. After 24 hours it was even more pronounced. The hepatocytes were shrunken. On the seventh day these alterations persisted in the central area only. None of these changes were found in the sham-operated controls. In electron microscopy rounding and swelling of the mitochondria was observed on the first day after dearterialization. On the seventh day they looked normal. Damage of the endoplasmatic reticulum was found to persist even on the seventh day. The bile canaliculi membrane was damaged after dearterialization but not after sham operation. Dilatation of the sinusoids and widening of the space of Disse was observed on the first and seventh day after dearterialization. In the controls none of these changes were seen. In both dearterialized and sham-operated dogs a transient decrease in liver glycogen was noted. In conclusion, light and electron microscopical studies demonstrated reversible ischemic changes in the liver. These correlated well with our liver pO2 measurements which indicated transient hypoxia and our biochemical studies which indicated reversible damage of the liver.     

A case of adult neuroblastoma arising in the retroperitoneal space

Neuroblastoma, common in children, rarely develops in adults. We recently treated a patient with adult neuroblastoma. A 34-year-old man complained of a swelling in right inguinal region. CT scan showed swelling of retroperitoneal and inguinal lymph nodes, and bone scintigram by 99mTc-HMDP showed an abnormal uptake in the swollen lymph nodes. Chemotherapy with CDDP (cisplatinum), VP-16 (etoposide), BLM (bleomycin), ADM (adriamycin) was not effective. Histopathological examination of a biopsy specimen revealed neuroblastoma. Another chemotherapy with CPM (cyclophosphamide), VCR (vincristine), ADM, DTIC (dacarbazine), CDDP, VP-16 was effective in decreasing the tumor size. Further high dose chemotherapy with CPM, ADM, CDDP, VP-16 combined with peripheral blood stem cell transplantation led to almost complete disappearance of the tumor and normalization of blood tumor markers (neuron specific enolase and immunosuppressive acidic protein). Retroperitoneal lymph node dissection demonstrated well-differentiated neuroblastoma in the excised tissue. Six months postoperatively, the tumor recurred in the pelvic cavity. Although chemotherapy and radiotherapy were given, he died of the disease 12 months postoperatively.     

Changes in muscle structure following tenotomy. A scanning electron microscopical study in the rat.

The alterations caused by Achilles tenotomy in the calf muscles of the rat were studied one, two and three weeks postoperatively by scanning electron microscopy (SEM). One week after tenotomy connective tissue had accumulated in endomyseal and perimyseal structures, which continued to increase even more after two and three weeks. The normal muscle architecture was markedly disturbed and in individual muscle cells hypercontracted segments, longitudinal splitting as well as destruction of myofilaments were found. Apparently due to the loss of muscle tension some muscle cells were reversed on their long axis and fixed with the adjacent collagen fibres. Some muscle cells were spiral in shape or crossing over each other. Formation of myotubes indicated onset of regenerative processes. According to the SEM-analyses tenotomy has many severe deleterious effects on muscle structure. In clinical practice tendon ruptures should therefore be repaired as soon as possible to avoid degenerative--potentially irreversible--changes in the muscular tissue.     

Immunocytochemical distribution of nitric oxide synthase in the human seminal vesicle: a light and electron microscopical study

Although nitric oxide (NO) has been proven to be one of the most important non-adrenergic, non-cholinergic mediators in the control of human reproductive tract organs, to date information on the significance of NO-mediated signal transduction in the control of human seminal vesicle (SV) function is still sparse. Recent investigations have underlined the significance of NO in the maintenance of sperm capacitation and viscosity of the seminal plasma as well as in the control of mammalian seminal vesicle smooth muscle tone. In order to further investigate the functional impact of NO on the regulation of normal SV function, we examined the distribution of NADPH-diaphorase (NADPH-d), endothelial nitric oxide synthase (eNOS) and neuronal nitric oxide synthase (nNOS) in the cellular anatomy of human SV by means of light and electron microscopical immunocytochemistry (LM, EM) in combination with the tyramide signal amplification technique. Human SV were obtained from 15 patients who had undergone surgery for pelvic malignancies (carcinoma of the prostate or urinary bladder). SV specimens were fixed, sectioned and examined by LM and EM for the presence of NAPDH-d, eNOS and nNOS using specific antibodies and advanced staining procedures. LM revealed a dense NADPH-d reaction in glandular epithelial structures, whereas no substantial labeling was detected in the fibromuscular stroma. EM showed that the NADPH-d reaction product was abundantly detectable attached to membranes of the endoplasmic reticulum, mitochondria and the nuclei of glandular epithelial cells. nNOS staining was found in nerve fibers branching within the SV tissue. eNOS staining was present in small vessels but was only observed to a minor degree in glandular and subglandular structures and the smooth muscle stroma. Our results support the hypothesis that human SV is a site of NO production. The distribution of NADPH-d may give rise to the speculation that NO is mainly involved in the regulation of SV secretory activity. The sparse correlation between NADPH-d-, eNOS- and nNOS-staining might hint at the existence of a previously unidentified NOS isoform in human SV.     

Re-evaluation of the immunohistochemical distribution of isoforms of nitric oxide synthase in the human prostate: A light and electron microscopical study

Up until today, there are still uncertainties regarding the occurrence of isoforms of the nitric oxide synthase (eNOS, nNOS) in the human prostate. While nNOS was exclusively seen in slender nerve fibres branching within the transition zone, eNOS was reported in glandular structures and also in small vessels interspersing the tissue. This study aimed to re-evaluate by means of light and electron microscopy (LM, EM), the distribution of eNOS and nNOS in the transition zone of the human prostate. Tissue specimens were obtained from 16 patients who underwent surgery for pelvic malignancies. Using specific antibodies in conjunction with advanced fixation and staining procedures, the occurrence of eNOS and nNOS was investigated. nNOS was detected in nerve fibres interspersing the tissue and was also seen in glandular structures. EM revealed that in glandular epithelial cells immunoreaction for nNOS was limited to the cytoplasmic compartment. Vascular endothelial cells of small vessels transversing glandular structures significantly stained for eNOS, while epithelial layers of prostatic glandules appeared free of eNOS. The results implicate that, in the prostate, nNOS is a mediator of stromal and glandular tissue function, and counteract the assumption of eNOS activity in glandular epithelial cells as a source of NO synthesis.     

Fanconi's syndrome in an adult. A case history.

A case of the Fanconi syndrome in an adult presenting with life-threatening hypokalaemia is described. Amino-aciduria, glycosuria, high phosphate and uric acid clearances with reduced plasma levels of these two substances, reduced urinary concentrating power and abnormal urinary potassium loss with a systemic acidosis, were the essential biochemical abnormalities. Osteomalacia was shown by a radiological bone survey.     

A light and electron microscopic study of oedematous human cerebral cortex in two patients with post-traumatic seizures

Primary objective : Brain cortical biopsies of two patients with clinical diagnosis of complicated brain trauma who had seizures, were studied by means of light and electron microscopes in order to correlate structural alterations with seizure activity.

Methods and procedures : Biopsy samples of left frontal cortex and right parietal cortex were processed by current techniques for light and transmission electron microscopy.

Results : The tissue showed severe vasogenic oedema with perivascular and intraparenchymatous haemorrhages. At the capillary wall, increased vesicular and vacuolar transendothelial transport, open endothelial junctions, thickened basement membrane and swollen perivascular astrocytic end-feet were observed. Some pyramidal and non-pyramidal nerve cells appeared dense and shrunken and others exhibited marked intraneuronal enlargement of membrane compartment. The myelinated axons displayed signs of degeneration and a process of axonal sprouting. Numerous swollen asymmetrical axo-dendritic synaptic contacts were observed in the neuropil, which exhibited mostly closely aggregated spheroidal synaptic vesicles toward the presynaptic membrane and numerous exocytotic vesicles sites. The perisynaptic astrocytic ensheathment appeared retracted or absent, whereas the extracellular space appeared notably dilated. Synaptic disassembly was also observed.

Conclusion : The findings demonstrate, in two patients with post-traumatic seizure activity, brain brarrier dysfunction, vasogenic oedema, anoxic-ischaemic neurons, axonal sprouting, numerous altered excitatory synapses and synaptic disassembly. Some considerations on clinical and research applications are discussed.     

A study of glucagonomas by light and electron microscopy and immunofluorescence.

Five tumors associated with the complete glucagonoma syndrome, as well as a series of glucagon-cell adenomas from three patients without this syndrome, were investigated by light and electron microscopy and by immunofluorescence. All tumors associated with the syndrome were large, from 3 to 35 cm along the major axis, and three of them were proved to be malignant. No common histologic arrangement of tumor cells was apparent for the five neoplasms examined. Immunofluorescent staining for glucagon and glicentin was carried out: while most cells were negative, a varying number of scattered cells were positive with both antisera in all tumors except one; three tumors contained more glicentin- than glucagon-immunoreactive cells. Moreover, three tumors were multihormonal, witn cells positive for pancreatic polypeptide and/or insulin. Ultrastructurally, the secretory granules of cells from these tumors were not typical of those found in A-cells from adult human islets. The glucagon-cell tumors from patients without the syndrome were benign, usually multiple, and were small, with diameters from 0.5 mm to 1 cm. In most cases, the cells from these neoplasms arranged in a characteristic pattern (ribbonlike or "gyriform"). In most tumors, the majority of cells showed both glucagon and glicentin immunofluorescence and the ultrastructural appearance of their secretory granules was similar to that of normal islet A-cells. From the morphologic point of view, therefore, cells from tumors not associated with the glucagonoma syndrome resemble normal glucagon cells more closely than those from tumors associated with the syndrome.