A case of cerebral glioblastoma with extensive cerebrospinal fluid dissemination: diagnostic value of immunohistochemical examination and MR imaging

A 9-year, 6-month-old boy presented with peripheral-type multiple cranial nerve palsy due to extensive cerebrospinal fluid (CSF) dissemination of intracranial glioblastoma multiforme. Tissue obtained from biopsydid not stain for glial fibrillary acidic protein (GFAP). The relationship between GFAP-negative tumor cells and extensive CSF dissemination agreed with recent reports. Magnetic resonance imaging with gadolinium-DPTA enhancement clearly depicted not only the cranial meningeal dissemination but also spinal metastasis. Magnetic resonance imaging showed undoubted usefulness in demonstrating disseminated glioblastoma.     

Glioblastoma in multiple sclerosis: a case report

Cerebral tumor and multiple sclerosis (MS) relapses can show overlapping clinical and magnetic resonance imaging features. In a previous study we observed in relapsing MS patients increased T-bet, pSTAT1, and pSTAT3 expressions in circulating mononuclear cells. During the data analysis we observed that T-bet, pSTAT1, and pSTAT3 expression was not increased in circulating mononuclear cells from a relapsing-remitting (RR)MS patient with recent onset of new neurological signs due to glioblastoma multiforme. In conclusion, our patient represents an exemplary case which suggests that T-bet, pSTAT1, and pSTAT3 expression in peripheral blood mononuclear cells (PBMCs) might be useful to differentiate MS relapses from other noninflammatory diseases.     

Molecular pathways in the formation of gliomas

The past few years have seen remarkable progress in understanding the molecular genetic basis of glioma formation. Affected oncogenes and tumor suppressor genes have been identified and putative tumor suppressor loci have been mapped. These studies have illustrated distinct molecular pathways for different glial neoplasms. We summarize the findings of an ongoing study initiated to characterize human gliomas on a molecular basis. The data are compiled from 150 astrocytic, oligodendroglial, and mixed gliomas that were assessed for genomic alterations characteristic of these neoplasms, i.e., loss of portions of chromosomes 1p, 9p, 10, 17p, 17q, and 19q, mutations of the p53 tumor suppressor gene, and amplification of the EGF receptor (EGFR) gene. Our findings support the hypothesis that distinct genetic pathways result in the formation of astrocytic and oligodendroglial neoplasms of different malignancy grades, and that glioblastoma multiforme may be subdivided into genetically distinct subsets. Such findings may not only lead to a better understanding of neoplastic transformation in glial cells, but may also have a major impact on clinical neuro-oncology. © 1995 Wiley-Liss, Inc.     

脑活素对体外培养脑胶质瘤细胞的作用

探讨脑活素的神经营养作用，以脑活素完全或部分替代小牛血清进行多形性胶质母细胞瘤体外细胞系培养。采用形态学观察和噻唑蓝比色分析法（ＭＴＴ）检测细胞增殖活性。结果发现，细胞增殖受抑制，形态退变，随脑活素剂量的增大，细胞存活率降低。提示在胶质瘤细胞培养中脑活素不能替代小牛血清所起的营养作用。     

人脑胶质母细胞瘤在不同周期时相中P16和P21的表达

目的 探讨人脑胶质母细胞瘤细胞株U-251MG在不同周期时相中P16和P21的表达。方法 采用高同步率、高收获率的细胞周期同步化方法,把U-251MG细胞同步在不同的时期,利用免疫组织化学方法检测在不同周期时相中P16、P21的表达。结果 P16在所有周期时相均有表达,而且在G_1期表达最强烈;P21在除S期以外其它周期时相均有表达,同样在G_1期表达最强烈。结论 U—251MG的细胞增殖受细胞周期负性调控因子P16和P21的影响,但它们有各不相同的作用时相和机制。     

Accelerated methaemoglobin formation: potential pitfall in early postoperative MRI

Summary Postoperative magnetic resonance imaging (MRI) of glioblastomas to assess residual tumour should be performed within the first 4 days following surgery. Early methaemoglobin formation near the resection site may mimic residual tumour if only gadolinium-DTPA-enhanced images are obtained. In a prospective study 24 of 54 patients (44%) showed well-defined areas of increased signal intensity on unenhanced T1-weighted images performed soon after surgery. By in vitro experiments we showed that hydrogen peroxide used in neurosurgery as a styptic agent accelerates formation of methaemoglobin when added to whole blood samples.     

Proliferative potential of vascular components in human glioblastoma multiforme

Summary Sixteen patients with glioblastoma multiforme received a 1-h intravenous infusion of 5-bromodeoxyuridine (BrdU), 150–200 mg/m² at the start of surgery, to label S-phase cells in tumor tissue. Labeled cells of vascular components and of tumor parenchyma were detected in excised tumor specimens by indirect immunoperoxidase staining using anti-BrdU monoclonal antibodies followed by periodic acid-Schiff staining. The BrdU labeling index (LI, defined as the percentage of labeled cells in relation to the total number of cells scored) was calculated separately for vascular components and tumor parenchyma in each specimen. The BrdU LI of vascular components of glioblastoma multiforme was remarkably higher than that of normal brain (1.1%–8.7% vs.<0.05%). The mean BrdU LIs of vascular components and tumor cells in eight primary glioblastomas were 4.5±0.8% (mean±SE) and 9.9±1.1%, respectively, while the corresponding BrdU LIs in eight recurrent tumors were 2.7±0.5% and 9.3±0.7%. The differences in the BrdU LIs of primary and recurrent tumors were not statistically significant, but the BrdU LI of vascular components was consistently much lower than that of tumor cells. BrdU labeling of vascular components was inconsistent and occurred mostly in glomerular-shaped vessels, but only about 20% of them contained labeled cells. These results suggest that unusual vascular proliferation, such as the formation of glomerular-shaped vessels and endothelial or adventitial proliferation, in glioblastoma multiforme may have been programmed to slow down or even to cease at a certain stage, and is not likely to be the result of neoplastic transformation.Supported in part by grant PDT-159 from the American Cancer Society and by grant CA 13525 from the National Cancer Institute     

脑恶性胶质瘤术后同步放化疗的潜在价值附5例长期生存报告

目的探讨脑恶性胶质瘤长期生存患者的主要治疗方法和安全性。方法比较分析5例经病理组织学证实的脑恶性胶质瘤长期生存患者的临床资料。结果尤以术后同步放化疗（卡莫司汀或紫杉醇）为主的治疗方法，患者的生存时间长，可达7年以上，且毒副反应轻微。结论术后同步放化疗对脑恶性胶质瘤患者具有潜在的治疗价值，并很少增加毒性反应。     

A multicentre prospective collection of newly diagnosed glioblastoma patients in Lombardia, Italy

Abstract The objective was to set the basis for a prospective, multicentre data collection on newly diagnosed adult glioblastoma patients diagnosed in Lombardia by means of a common database used by neurological and neurosurgical units of various hospitals, providing epidemiological, therapy and follow-up data. All adult patients with a newly diagnosed glioblastoma in 9 Lombardia hospitals from 31 March 2003 to 31 March 2004 were followed prospectively by a form elaborated by the Lombardia Neuro-oncology Group. Demographic data were recorded, as well as symptoms at onset, entity of tumour resection, post-surgical Karnofsky Performance Score, radio- and chemotherapy, presence/absence of venous thrombosis, type of antiepileptic treatment, time to tumour progression and survival time (ST). One hundred and thirty-four newly diagnosed glioblastoma patients were enrolled during the first year of the study. Male/female ratio was 1.6:1. Median age was 61 years. The most common single sign/symptom at disease onset included seizures, followed by mood/cognition changes and headache. In 71 patients, the tumour involved 1 brain lobe at diagnosis. Twenty-five patients underwent biopsy, 51 partial removal and 51 grossly total removal. At analysis of predictive value on ST, grossly total resection and chemotherapy were significantly associated with a longer ST. Age younger than 50 showed a trend to predictive value. A very high proportion of patients were treated with antiepileptic drugs, even in the absence of seizures. Median ST was 12 months in our cohort. Data in newly diagnosed glioblastoma patients in Lombardia are in line with other case series reported in other populations.     

Virus-like particles in cultured human glioma

Summary Mature type C virus-like particles were found in the extracellular site of human glioblastoma multiforme cells cultured in bottles for 30 days after inoculation. They were target-like in feature and about 100–110 m in diameter, surrounded by a limiting membrane. A homogeneously dense core, around 60–70 m in diameter, was located in the center of the particle. Evidence for the presence of other forms of virus-like particles or for the budding at the cell membrane of virus-like particles was not yet found.

---

Zusammenfassung Reife, virusähnliche Partikel vom Typ C fanden sich in einem menschlichen Glioblastoma multiforme 30 Tage nach Inoculation auf Flaschen-Zellkulturen. Die Partikel waren ringförmig mit einem Durchmesser von 100–110 m und von einer Membran messer. Hinweise auf das Vorliegen anderer Formen virusartiger Partikel oder auf eine Entstehung virusähnlicher Partikel an der Zellmembran fanden sich noch nicht.