Leptomeningeal myelomatosis mimicking a subdural haematoma

We report a rare appearance at presentation of meningeal myelomatosis without bone involvement, in the form of an extra-axial mass of mixed density, resembling a chronic subdural haematoma. Received: 24 September 1999/Accepted: 12 January 2000     

Dural enhancement in pituitary macroadenomas

We describe the normal dural enhancement patterns of the sellar region and determine whether the duramater is affected by pituitary macroadenomas. Dural enhancement appeared to be usually abnormal in 20 patients with pituitary macroadenoma compared with 20 control patients, mainly at the planum sphenoidale and carotid sulcus. However dural changes are subtle and their recognition requires knowledge of the normal enhancement patterns. Dural changes, reported in a variety of inflammatory and infectious dural diseases and after surgery, are not specific and may be also seen in pituitary macroadenomas. Received: 12 December 1998 Accepted: 3 November 1999     

Nasal administration of mesenchymal stem cells reverses chemotherapy-induced peripheral neuropathy in mice

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequently reported adverse effects of cancer treatment. CIPN often persists long after treatment completion and has detrimental effects on patient’s quality of life. There are no efficacious FDA-approved drugs for CIPN. We recently demonstrated that nasal administration of mesenchymal stem cells (MSC) reverses the cognitive deficits induced by cisplatin in mice.Here we show that nasal administration of MSC after cisplatin- or paclitaxel treatment- completely reverses signs of established CIPN, including mechanical allodynia, spontaneous pain, and loss of intraepidermal nerve fibers (IENF) in the paw. The resolution of CIPN is associated with normalization of the cisplatin-induced decrease in mitochondrial bioenergetics in DRG neurons. Nasally administered MSC enter rapidly the meninges of the brain, spinal cord and peripheral lymph nodes to promote IL-10 production by macrophages.MSC-mediated resolution of mechanical allodynia, recovery of IENFs and restoration of DRG mitochondrial function critically depends on IL-10 production. MSC from IL-10 knockout animals are not capable of reversing the symptoms of CIPN. Moreover, WT MSC do not reverse CIPN in mice lacking IL-10 receptors on peripheral sensory neurons. In conclusion, only two nasal administrations of MSC fully reverse CIPN and the associated mitochondrial abnormalities via an IL-10 dependent pathway. Since MSC are already applied clinically, we propose that nasal MSC treatment could become a powerful treatment for the large group of patients suffering from neurotoxicities of cancer treatment.     

中枢神经系统脑脊膜黑色素细胞瘤三例及文献复习

目的 探讨中枢神经系统脑脊膜黑色素细胞瘤(PMM)临床及病理学特征.方法 结合文献复习,回顾性分析3例中枢神经系统原发的脑脊膜黑色素细胞瘤.结果 2例肿瘤位于椎管内,1例位于小脑脑桥角.肿瘤外观呈黑色,部分肿瘤包膜完整.光镜下见瘤细胞由上皮样细胞和梭形细胞混合而成,细胞无明显异型,核仁明显.大部分瘤细胞质内含有大量黑色素颗粒.例1、例3肿瘤核分裂像无或偶见(0～1个/10 HPF),例2核分裂像较多(2～3个/10 HPF).免疫表型HMB45、MelanA和S-100蛋白呈阳性表达.例1、例2肿瘤完全切除,例3部分切除,随访均无复发.结论 原发性脑脊膜黑色素细胞瘤是一种罕见的交界性或低度恶性肿瘤,具有一定的病理学特征,可局部复发或发生恶变,需要与原发或转移的恶性黑色素瘤、黑色素性脑膜瘤及黑色素性神经鞘瘤进行鉴别.     

IgG4相关性脑膜病变

目的探讨Ig G4相关性脑膜病变的临床病理学特征以及诊断与鉴别诊断要点。方法与结果男性患者,49岁,临床表现为头痛近2年并进行性加重1月余,头部MRI显示左侧顶叶占位性病变,增强扫描可见"脑膜尾征",手术完整切除病灶。组织学形态,左侧顶叶硬脑膜和脑实质大量胶原纤维增生,其间散在灶状细胞浸润,多为较成熟的浆细胞,部分浆细胞内可见匀质红染的Russell小体,其间散在淋巴细胞和少量嗜酸性粒细胞,局部可见小灶状坏死,间质纤维母细胞和小血管增生,未见包膜,病变累及周围脑组织。免疫组织化学染色,浆细胞胞质弥漫性表达Ig G和Ig G4(60%)、胞膜表达CD38和CD138,淋巴细胞胞膜表达CD3、CD4或CD20。血清Ig G4为1.05 g/L。最终病理诊断为(左侧顶叶)Ig G4相关性脑膜病变可能性大。术后予抗感染、抗癫、营养支持治疗,症状明显好转,出院后未按医嘱定期随访。结论 Ig G4相关性脑膜病变临床少见,且缺乏典型临床表现和特征性影像学改变,术前诊断与鉴别诊断困难,血清Ig G4水平升高是其诊断的重要线索,明确诊断仍需依靠特征性的组织学形态和免疫组织化学表型。     

A correlation of the surgical anatomy of the dura to head and neck surgery

Summary Head and neck surgery may be complicated by penetration of the dura resulting in meningitis, cerebrospinal rhinorrhoea, cerebral abscess or other intracranial complications. The strength of the dura mater both protects the brain and spinal cord and makes dura an ideal material for grafting (when needed). This study examines the thickness and histological composition of dura mater at various sites encountered in head and neck surgery. Dura was removed from eight specified locations in 14 adult cadavers. Microscopically, this dura was found to consist predominantly of collagen fibres, although the thickness of the dura varied between sites. Dura was significantly thinner in relation to the ethmoid sinus (P<0.01), tegmen (P<0.05) and sigmoid sinus (P<0.001), indicating its greater susceptibility to possible injury at these sites during surgery. The variety of its thickness also makes dura a more versatile homograft material than hitherto realised.Presented at the meeting of the British Association of Clinical Anatomists, Newcastle-upon-Tyne, England, 13 September 1985     

脑脊膜血管外皮瘤的临床病理研究

背景与目的：原发于脑脊膜的血管外皮瘤临床少见。本文回顾分析我院收治的20例,探讨其临床病理特征,组织学发生及生物学行为。方法：结合临床资料,运用组织病理学和免疫组化方法观察20例原发于脑脊膜的血管外皮瘤,并对其中4例进行透射电镜观察。结果：本病中位年龄42.4岁,男女之比1.2:1。临床上多以头痛等症状就诊,肿瘤可发生在颅内脑脊髓表面的任何部位,大体上：肿瘤多似有包膜,质地韧,部分呈鱼肉样,组织学;肿瘤组织内血管丰富,可见典型的“鹿角样”血管,血管周围为短梭形的肿瘤性外皮细胞,沿血管呈放射状分布,瘤细胞异形,见核分裂像,网状纤维染色;嗜银纤维围绕单个瘤细胞,并沿血管呈放射状分布。免疫组化标记;瘤细胞除Vim阳性外,其余S-100蛋白,FⅧ,EMA,GFAP和CD34均阴性,电镜：瘤细胞中见丰富的10nm的中丝,细胞外基膜明显,并围绕单个瘤细胞分布,随访;获随访的17例病人中8例复发（占47.1%)。结论：脑脊膜的血管外皮瘤为起源于脑脊膜间叶组织,低度恶性的肿瘤,组织学形态,免疫表型和超微结构类似于软组织的血管外皮瘤。     

Immunofluorescence studies on localization of actin-like protein in the mouse brain

Summary Localization of actin-like protein in the mouse brain was studied by the immunofluorescence method using FITC-labeled antiactin antibody. Antibody against actin was prepared according to Lazarides (1974). The problem of poor antigenicity and the presence of contaminants in the antigen preparation was circumvented by way of denaturation of the protein with sodium dodecyl sulfate (SDS) and subsequent purification of the antigen by SDS polyacrylamide gel electrophoresis (Lazarides, 1974). Intense specific fluorescence against actin was noted in the cytoplasma of the epithelial cells of the choroid plexus, of the ependymal cells of the ventricles, and a little less one in arachnoidea and in leptomeninges, as well as in the muscle layers, endothelial linings, and adventitia of the arteries. Diffuse but weak fluorescence was noted also in the neuropil of the grey matter of the brain. Among the latter, fluorescence in the granular layer of Ammon's horn and of the cerebellum appeared clearer than the diffuse one in the rest of the grey matter. Functional significance of the presence of actin-like protein in the above tissues was discussed.