Junko Hirato

Oligodendroglial Microtubular Tangles in Olivopontocerebellar Atrophy

Oligodendroglial microtubular tangles (OMT), a distinctive oligodendroglial change, was observed in seven of eight cases of olivopontocerebellar atrophy (OPCA). This change was a well-defined glassy cytoplasmic structure showing intense argyrophilia. OMT were distributed in the brain stem, cerebellum, and basal ganglia where severe neurodegenerative changes were consistently observed. In 45 control cases, no OMT were found regardless of the presence or absence of neurological disorders. The OMT were immunostained by anti-tubulin antibodies, but no other antibodies reacted with them. Each OMT consisted of a meshwork of randomly oriented fibrils studded with granular and fuzzy material. The fibrillary elements were between 20 and 30 nm in diameter. It is suggested that OMT are primarily composed of altered microtubules, and are related to the neurodegenerative process of OPCA.

Pathology of pineal region tumors.

Various histological types of tumors arise in the pineal region. The most common tumors are pineal parenchymal tumors and germ cell tumors. Pineal parenchymal tumors are divided into pineocytoma, pineal parenchymal tumor with intermediate differentiation and pineoblastoma. Pineocytomas are well-differentiated tumors and retain the morphological and immunohistochemical features of pineal parenchymal cells. Lobular architectures and pineocytomatous rosettes are also typical features. In contrast, pineoblastomas are embryonal tumors resembling primitive neuroectodermal tumors (PNET). However, pineoblastomas are distinct from PNET in other sites due to their exhibiting photosensory differentiation including Flexner–Wintersteiner rosettes and fleurettes. Although pineal cysts are tumor-like lesions, and not true neoplasms, they are occasionally difficult to distinguish from pineocytoma and astrocytoma. From the therapeutic aspect, a precise differential diagnosis is critical.The pineal region is the most common site of the brain in which germ cell tumors occur. Germinoma, teratoma, embryonal carcinoma, yolk sac tumor and choriocarcinoma are encountered, and the latter three types of tumors usually constitute elements of mixed germ cell tumors. The morphological and immunohistochemical features of intracranial germ cell tumors are very similar to those of gonadal germ cell tumors, although there are some differences in germinoma. Pineal germinoma may exhibit carcinomatous differentiation.Other types of tumors are occasionally observed, including fibrillary and pilocytic astrocytoma, glioblastoma, ependymoma, melanoma, meningioma and so on. Metastatic pineal tumors are also rare. The most common site of origin for pineal metastasis is the lung.

Anti-Human Olig2 Antibody as a Useful Immunohistochemical Marker of Normal Oligodendrocytes and Gliomas

Olig2 is a recently identified transcription factor involved in the phenotype definition of cells in the oligodendroglial lineage. The expression of Olig2 transcript has been demonstrated in human oligodendroglial tumors, although the protein expression has not been studied extensively. We developed a polyclonal antibody to human Olig2 and analyzed it immunohistochemically. The antibody depicted a single distinct band of predicted molecular weight by Western blotting, and did not cross-react with human Olig1. In normal human brain tissue, the nuclei of oligodendrocytes of interfascicular, perivascular, and perineuronal disposition were clearly labeled by the antibody. Similarly, the nuclei of oligodendroglial tumors were labeled. There was no apparent correlation between the staining intensity and histological grade. Astrocytic components within the tumors were generally less or not stained. Astrocytic tumors were also positive with the Olig2 antiserum to a lesser extent, and the difference between oligodendroglial and astrocytic tumors was demonstrated by a statistical analysis. Olig2 and glial fibrillary acidic protein were expressed in a mutually exclusive manner, and Olig2 expression was cell-cycle related. Neither central neurocytoma nor schwannoma cases were stained. Our antibody was demonstrated to be useful in recognizing normal oligodendrocytes on paraffin sections, and applicable in diagnosis of some brain tumors.

LMO3 Interacts with Neuronal Transcription Factor, HEN2, and Acts as an Oncogene in Neuroblastoma

LIM-only proteins (LMO), which consist of LMO1, LMO2, LMO3, and LMO4, are involved in cell fate determination and differentiation during embryonic development. Accumulating evidence suggests that LMO1 and LMO2 act as oncogenic proteins in T-cell acute lymphoblastic leukemia, whereas LMO4 has recently been implicated in the genesis of breast cancer. However, little is known about the role of LMO3 in either tumorigenesis or development. In the present study, we have identified LMO3 and HEN2, which encodes a neuronal basic helix-loop-helix protein, as genes whose expression levels were higher in unfavorable neuroblastomas compared with those of favorable tumors. Immunoprecipitation and immunostaining experiments showed that LMO3 was associated with HEN2 in mammalian cell nucleus. Human neuroblastoma SH-SY5Y cells stably overexpressing LMO3 showed a marked increase in cell growth, a promotion of colony formation in soft agar medium, and a rapid tumor growth in nude mice compared with the control transfectants. More importantly, the increased expression of LMO3 and HEN2 was significantly associated with a poor prognosis in 87 primary neuroblastomas. These results suggest that the deregulated expression of neuronal-specific LMO3 and HEN2 contributes to the genesis and progression of human neuroblastoma in a lineage-specific manner.

Immunohistochemical study of microglia in the Creutzfeldt-Jakob diseased brain

Immunohistochemical techniques have been used to investigate microglial reaction in Creutzfeldt-Jakob diseased (CJD) brains. Autopsy cases of six patients with CJD and age-matched controls were studied. Formalin-fixed, paraffin-embedded brain tissue samples were stained with antibodies against major histocompatibility complex (MHC) class II antigen (Ag), leukocyte common antigen (LCA), CDw75, CD68 and glial fibrillary acidic protein. Of the patients with CJD, two with a subacute spongiform encephalopathic type and short-survival periods after onset of the disease showed an increased number of reactive microglia labeled with anti-MHC class II Ag or LCA in the affected cerebral cortex. In advanced cases of the panencephalopathic type of CJD, in which both cerebral atrophy and astrocytosis were marked, the increase of reactive microglia was small. Some vacuoles developing in the neuropil of the CJD patients were surrounded by MHC class II Ag- or LCA-immunoreactive microglial cells. The number of ramified microglia in the affected lesions was decreased, although their number in the hippocampus was not affected. These results indicate that microglia can frequently be involved in the process of CJD and may be activated at the early stage of the disease.

Immunohistochemical localization of neurofilament protein in neuronal degenerations.

SummaryThe immunohistochemical localization of human neurofilament proteins was studied in a variety of neuronal changes by the peroxidase-antiperoxidase method using antisera raised against each of the subunit proteins of human neurofilament. Torpedoes of the cerebellum, axonal spheroids of amyotrophic lateral sclerosis as well as of infantile neuroaxonal dystrophy, and neurofibrillary changes in a case of Picks disease were consistently immunostained. Occasionally, a positive immunoreactivity was also observed in Lewy bodies, in neurofibrillary tangles of progressive supranuclear palsy, and in neuritic processes of senile plaques. Neurofibrillary tangles of Alzheimer type and Picks bodies, however, did not react with the antisera. These data indicate that the human neurofilament doesnot share major antigenic determinants of its subunit protein with either Alzheimers neurofibrillary tangles or Picks bodies.

Significance of epidermal growth factor receptor gene mutations in squamous cell lung carcinoma

Epidermal growth factor receptor (EGFR) gene mutations have been reported to be clinically significant in non-small cell lung cancer (NSCLC). However, because most previous studies focused only on adenocarcinomas, EGFR mutations in other histotypes are poorly investigated. We evaluated the frequency of EGFR gene mutations in squamous cell carcinoma (SCC) and its clinicopathological features. In total, 89 frozen tumor specimens that had been first diagnosed as SCCs, were examined for EGFR mutations in exons 19 and 21 using direct sequencing, PNA-enriched sequencing and SmartAmp2. Additionally, pathological investigation, including immunostaining for p63 and TTF-1, alcian blue staining and EGFR mutation-specific immunohistochemistry in mutation-positive samples was also performed. The frequency of EGFR mutations was 5.6% (5/89); all mutations were deletions in EGFR exon 19. Immunohistological investigation of these samples revealed that two of five were positive for p63 and TTF-1 staining, and showed production of mucin, as evidenced by alcian blue staining. Consequently, three of the samples were considered to be true SCC at final pathological diagnosis, while the remaining two samples were revised to adenosquamous carcinoma and adenocarcinoma. The final frequency of the EGFR mutations in true SCC was 3.4% (3/87). In conclusion, EGFR mutations were found in a small, but significant, number of SCC tumor samples and thus EGFR mutational analysis was useful in the accurate diagnosis of SCC. Our data demonstrate that EGFR mutational analysis should be performed not only in adenocarcinoma, but also in SCC to allow accurate diagnosis and treatment.

Immunohistochemical study of the early human fetal brain

SummaryTo assess the cytogenesis of the central nervous system we studied the spinal cord and the cerebrum in 11 human embryos and fetuses of gestation age 7–25 weeks immunohistochemically using anti-vimentin, anti-neurofilament protein (NFP), anti-neuron-specific enolase (NSE), anti-glial fibrillary acidic protein (GFAP), anti-S-100 protein, anti-Leu 7 and anti-myelin basic protein (MBP) antibodies. Vimentin was demonstrated in ventricular cells at 7 weeks and older. NFP-68-kDa and-160-kDa components were observed in neuroblastic cells of the neural tube at 7 weeks. NFP (68 and 160 kDa) was mainly located in the marginal zone of the spinal cord and the cerebrum at 8–9 weeks. NSE was not found in the neural tube at 7 weeks, although NSE was demonstrable at 9 weeks both in the spinal cord and in the cerebrum. GFAP-positive cells started to appear at 9 weeks in the spinal cord and at 15 weeks in the cerebrum, respectively. S-100 immunoreactivity was almost coincident with GFAP. S-100, however, was observed in more numerous glioblastic cells. Leu 7 was detected at 7 weeks and located in the neuropil of the central nervous tissue. MBP was not demonstrable in this study. Our study indicates that neuronal differentiation occurs much earlier than glial differentiation in the human brain and that neuronal and glial cell classes do not coexist in the ventricular zone of the early human fetal brain.

Solitary fibrous tumor of the orbit with extraorbital extension: case report.

OBJECTIVE AND IMPORTANCE Solitary fibrous tumors (SFTs) are rare tumors of mesenchymal origin that typically arise in the pleura. Only 24 cases of SFTs in the orbit have been reported, all located within the orbit and generally with a benign course. We report the first case of an orbital SFT with extraorbital extension and short-term regrowth. CLINICAL PRESENTATION A 54-year-old man presented with proptosis and double vision that had persisted for 7 months. The tumor extended from the right extraconal inferolateral orbit to the extradural middle cranial fossa and cavernous sinus, via the superior orbital fissure, on magnetic resonance imaging scans. Positron emission tomography with [18F]fluorodeoxyglucose demonstrated faint uptake in the orbital portion. INTERVENTIONResection of the tumor was performed twice, because of short-term regrowth of the residual tumor in the orbit. The histological diagnosis was a SFT. The MIB-1 labeling index was 7% and the mitotic count was 5 mitotic figures/10 high-power fields at the time of the second operation. These findings indicate the malignant nature of the tumor. CONCLUSIONThe natural history of SFTs of the orbit remains unclear, and the importance of careful and continued follow-up monitoring of the tumor should be emphasized.

An unusual variant of ependymoma with extensive tumor cell vacuolization

Abstract We report a case of ependymoma with unusual vacuolar features arising in the left occipital lobe of a 2-year-old child. The tumor was composed of cells with single or multiple cytoplasmic vacuoles and clear cells. Some cells showed a signet ring-like configuration. Clear cells were compactly arranged and showed an oligodendroglioma-like appearance. In addition, there were cellular ependymoma-like areas including perivascular pseudorosettes. On immunohistochemistry, glial fibrillary acidic protein and vimentin were mainly detected in cytoplasmic processes, and epithelial membrane antigen (EMA) staining showed granular and small vesicular reactivity. Ultrastructural investigation demonstrated intercellular microrosettes with or without cilia and long zonula adherens-type junctions that are typical of ependymoma. Furthermore, many intracytoplasmic lumina (ICL) were observed. Some ICL had microvilli and some did not. The latter varied in size, and may have fused with each other to develop giant ICL which could correspond to the signet ring-like configuration. Small ICL without microvilli had an appearance similar to that of distended endoplasmic reticula. Serial semithin and ultrathin sections revealed that EMA-positive structures were consistent with ICL containing microvilli and intercellular microrosettes. To determine the presence of unusual vacuolated ependymoma, electron microscopical examination was required. However, light microscopy was useful for detecting EMA-positive microvesicular and granular structures.