K. J. Zülch

Brain tumors : their biology and pathology

an internationally recognized authority, the reviewer can only repeat his comments upon the earlier edition, for the main body of the work remains unchanged. In a comparatively short compass the author has managed to achieve a well balanced and discriminating systematic condensation of a huge literature and of his own wide experience in the pathology of brain tumors. The book is addressed to the needs and interests of clinicians. The first half of the work is devoted to the general characteristics of brain tumors : their classification, structure, age and sex incidence, preferential localization, and displacements of intracranial structures. These topics are discussed always with their diagnostic and prognostic significance in mind. Although the authors classification of the neuroepithelial tumors follows closely the histogenetic one of Bailey and Cushing, he insists rightly upon the importance of avoiding too great a dependence upon the cell type alone for morphological diagnosis, and emphasizes the neces¬ sity of giving full consideration to the total archi¬ tecture of the tumor and its manner of growth. The remainder of the book is concerned with the gross and microscopic anatomy of the indi¬ vidual tumor types, illustrated by well chosen photographs of excellent technical quality. The new edition has been revised by the addition to the appropriate chapters of a brief resume of the re¬

Morphology of malignant gliomas induced in rabbits by systemic application of N-Methyl-N-nitrosourea

Summary1. Adult rabbits received intravenous injections of N-Methyl-N-nitrosourea (10 mg/kg) every two weeks. Of 25 animals 14 (48%) developed malignant tumors of the central nervous system. The average total dose was 150 mg/kg and the mean survival time was 349 days from the beginning of the experiment.2. All tumors of the central nervous system originated in the cerebral hemispheres with a preferential location in the periventricular zones of the lateral ventricles.3. Histopathologically, most tumors were classified as oligodendrogliomas or mixed gliomas with varying degrees of cellular dedifferentiation, and as ependymomas.

Störungen des intrakraniellen Druckes

Wir diagnostizieren in der Neurochirurgie die raumfordernden und die schrumpfenden Prozesse des Hirns auf Grund der Symptome in der Vorgeschichte, im neurologischen und im rontgenologischen Befund. Die Symptome entstehen durch die Beeintrachtigung des Schadel- oder Hirngewebes. Infolge der Eigenart der physikalischen Bedingungen im Schadelinnenraum und im Hirn kann sich der Einflus des krankhaften Prozesses — wie wir noch sehen werden — auf das Hirngewebe und seine Funktionen in direkter Nahe des Herdes, aber auch fernab bemerkbar machen.

Formale Pathogenese experimenteller Hirntumoren

SummaryRecent experimental results with resorptive carcinogens, inducing tumors of the nervous system, raise the question, whether similar factors may account as well for man. To answer this question, it seems necessary to consider well proved data of human neurooncology as well as aspects of formal pathogenesis in the field of experimentally induced neoplasms.In the experimental production of nervous tumors with resorptive carcinogens, some characteristics are interesting:1.The prominent malignancy of the resulting tumors. This fact can be explained by taking the peripheral neurinomas as an example of the experimental tumors, which correspond almost exclusively to human “malignant neurinomas” or “neurosarcomas”.2.Moreover “multicentric” and “mixed” tumors are regulary found. Pure gliomas in rats only grow in the early stages; later on and particularly in the large pleomorphic brain tumors an admixture of other cell types is met, occasionally with a net separation of center and periphery.3.In the experiments more frequently also very rare blastomas of human pathology can be observed. For instance in certain experimental models some tumors are quite comparable with the medulloepitheliomas or (esthesio-) neuroepitheliomas in man.4.The species of the animals used in the experiments is of considerable influence regarding the kind of the resulting tumors. The knowledge of spontaneous tumors in animals is important in order to evaluate the real oncogenic effect of some of the applied substances. Pituitary adenomas, for instance, which occur in rats spontaneously or after treatment with estrogens are also seen in experiments with resorptive carcinogens, but they may be probably “spontaneous” tumors.5.For the pronounced malignancy and the multiplicity of tumor growth the grade of the carcinogenic stimulus may be responsible. Pathogenetic considerations explaining the mixed nature of the resulting neoplasms are discussed. The influence of species on the kind and localisation of the resulting tumors might be amongst others due to anatomical factors, which are, however, still unknown. In addition to these special features of formal pathogenesis of experimentally induced brain tumors, statistical data of spontaneous tumor growth in man-as age-, sex-, topic distribution and the spectrum of the occuring tumors have to be taken into account.

Pyramidal and Parapyramidal Motor Systems in Man

The localization of function in the brain started with the observation of dramatic forms of paralysis of motor movements and this dates back to ancient history. The development of our knowledge is well documented in our introductory chapter. In this paper a general view of our own observations and interpretations in man following localized lesions, both in surgical operations and in trauma and cerebrovascular accidents, will be given (ZULCH, 1942–1974).

Zur Morphologie transplacentar erzeugter neurogener Tumoren beim Goldhamster

SummaryPregnant Syrian hamsters were given 30 mg/kg ethylnitrosurea on the 15th day of pregnancy. Among 29 newborn animals, 22 could be grown up, 14 of which developed malignant tumors. Besides tumors of the trigeminal nerve which appeared first, particularly tumors of peripheral nerves were observed. In addition one nephroblastoma and one melanoma of the subcutis were induced. There were no tumors of the brain and spinal cord. The peripheral nervous tumors showed intensive regressive changes. In general, these tumors can be classified within the group of “malignant neurinomas”.

Intracranial Tumours of Infancy and Childhood

The fact that in the last 50 years particular chapters or books have been published on this special subject could have two causes: (1) that diagnosis and treatment in this particular age group need special discussion and advice, or (2) that the pathology of tumours is different so that whereas some intracranial tumours occur in all ages, some other tumours develop preferentially or sometimes exclusively in infants and children [591.

Gross vascularization of experimentally induced transplanted tumors of the central and peripheral nervous system

SummarySubcutaneously and intracerebrally transplanted neurinomas as well as intracerebrally grafted gliomas, both derived from primary tumors with resorptive carcinogens were investigated after injection of micropaque by conventional histologic methods and by postmortem X-ray analysis. Growth pattern and vasculature were similar in subcutaneously and intracerebrally transplanted malignant neurinomas. The most common feature was a parallel arrangement of vessels as shown by microradiography and vessel free zones. In intracerebrally grafted glioma, the growth of tumors was confined to or starting from the ventricular system. Sinusoidal vessels, capillary proliferations and proliferation of vessel wall were found. The outstanding feature was the occurrence of extravascular contrast deposits, thus indicating the vulnerability of tumor vessels and frequency of hemorrhages into these tumors.

Perfusion patterns in CT transit studies.

SummaryTransit studies consist of a rapid sequence of single cross-section CT scans performed during and following the bolus injection of contrast medium into the venous system. The low vascular volume of the brain leads to small changes in attenuation thereby reflecting the perfusion of vasculature. Studies were carried out following 45 examinations on 24 stroke patients and 15 tumor patients. Hypo-, normo- and hyperperfusion were observed in different tissue categories and related to specific tissue elements. The comparison of perfusion patterns with pre-contrast CT values and enhancement after 5 min elucidates cerebral hemodynamics in hypodense to hyperdense lesions with or without damage of the blood-brain barrier (BBB)Cystic lesions and edema were found to have slight damage of the BBB and markedly reduced perfusion. Infarcts demonstrated, depending on their state of evolution to cystic defects or recovery to normal, hypoperfusion and extravasation of contrast medium or hyperperfusion with or without damage of the BBB. A diagnostically valuable difference between edema and infarcts was seen in the phase of stable distribution after 5 min. In most tumors hypervascularity and pathological extravasation were seen, whereby the cause of enhancement could be differentiated.Owing to the properties of the contrast medium used, and to the fact that transit times can not yet be measured, quantification of CBV and CBF was not possible. Definition of large cerebral vessels, especially in the neighborhood of brain tumors, and the improvement in detectability of small lesions by low dose contrast injection, will be demonstrated as a spin-off of CT transit studies.

Brain tumor chemotherapy using a rat glioma model.

SummaryThe antitumor agent chloroethyl-cyclohexyl-nitrosourea (CCNU) was examined using a rat glioma model. A i.p. administration of three times 40 mg/kg CCNU was highly effective and increased the life-span of tumor-bearing rats from 53 to 86%. A total quantity of CCNU amounting to less than 30 mg/kg was not effective. On the other hand, large dosages exceeding LD10 proved to be toxic.The depression of platelets and white blood cells was mild after a single dosage of 40 mg/kg CCNU which recovered on about the 6th day.In the CCNU-treated animals there was an increase of the extent of necrobiosis. Ballooning of tumor cells with nuclear pyknoses and a lack of mitotic features occurred. Microcystic changes appeared sometimes to be more frequent than in control groups.