Ligia Maria Barbosa Coutinho

Immunohistochemical evaluation of the microvascular density through the expression of TGF-β (CD 105/endoglin) and CD 34 receptors and expression of the vascular endothelial growth factor (VEGF) in oligodendrogliomas

Angiogenesis has been proposed as essential for the growth of solid tumors. The determinants of this process, the growth factors and the vascular endothelial receptors have brought a potential in the tumor prognostic determination as well as perspectives of “targets” for antiangiogenic therapy. In oligodendrogliomas (OL), angiogenesis is little known and/or has generated conflicting results. In order to clarify angiogenesis in OL, we have evaluated the immunohistochemical expression of vascular endothelial growth factor (VEGF) and the microvascular density (MVD) through the expression of TGF‐β (CD105/endoglin) (MVD‐CD105) and CD34 (MVD‐CD34) receptors using the Chalkley point method in 30 OL. No significant immune reaction was found for the VEGF. There was expression in <10% of tumor cells and/or staining of weak intensity in 15 (50.0%), >10% of cells and moderate intensity staining in 1 (3.33%), and negative expression in 14 (46.67%). If present, the expression was restricted to tumor and endothelial cells. Our findings suggest that VEGF has little influence on OL angiogenesis. All specimens showed CD105 and CD34 expression in the intratumor vascular endothelium, suggesting involvement of CD105 in OL angiogenesis. The mean ± SD MVD‐CD105 and MVD‐CD34 were 10.83 ± 2.24 and 11.00 ± 2.76 in OL (P = 0.086; r = 0.319); 10.00 ± 2.00 and 10.40 ± 3.02 in OL grade II (n = 15) (P = 0.547; r = 0.105), and 11.67 ± 2.22 and 11.53 ± 2.45 in OL grade III (n = 15) (P = 0.817; r = 0.551), respectively. The absence of correlation between DMV‐CD105, DMV‐CD34 and tumor grades suggests that anti‐CD105 and anti‐CD34 antibodies have different vascular specificities. MVD‐CD105 was greater in OL grade III than in OL grade II (P = 0.0032), indicating an increase in the vascular neoformation, something which must be evaluated as a possible prognostic factor in OL. Both TGF‐β and CD105 bring perspectives as “targets” for antiangiogenic treatments in OL.

Metastase de carcinoma comprometendo a cauda equina

: The case of a 60 year-old man who had an indifferenciated carcinoma in the lung is reported. He had received cobaltotherapy and had improved. After 3 months a lumbar pain had began and the patient was hospitalized. A myelography with lipiodol demonstrated and intra-dural mass. At operation a big intra-dural tumor including the cauda equina was found. The microscopic examination revealed an undifferenciated carcinoma, that inflitrated the epi and peri-nerual space.The case of a 60 year-old man who had an indifferenciated carcinoma in the lung is reported. He had recieved cobaltotherapy and had improved. After 3 months a lumbar pain had begun and the patient was hospitalized. A myelography with lipiodol demonstrated an intra-dural mass. At operation a big intra-dural tumor including the cauda equina was found. The microscopic examination revealed an undifferenciated carcinoma, that infiltrated the epi and peri-neural space.

Hemorragias em metastases intracranianas de melanoma: registro de dois casos

Two cases of intra-cerebral haemorrhage secondary to malignant melanoma metastasis are reported. When dealing with subarachoid haemorrhages, one should think of brain secondaries and a biopsy should always be performed whenever a spontaneous intra-cerebral hematoma is found.Sao relatados dois casos de metastases cerebrais de melanoma maligno cuja manifestacao clinica foi de hemorragia cerebro-meningea. E feita a revisao da literatura pertinente, enfatizando-se a importância da inclusao das metastases no diagnostico diferencial das hemorragias cerebrais e da realizacao de biopsia da parede de hematomas intra-cerebrais espontâneos.

Peritumoral brain edema in intracranial meningiomas

Occurrence of peritumoral brain edema (PBE) in meningiomas has been associated with several factors in recent years, although its pathophysiological mechanism has not yet been fully elucidated. The aim of this study was to analyze the correlation between the presence / degree of PBE and factors such as gender, age, size and histological subtype of tumor. We analyzed the MRI images of 74 patients operated on Hospital Beneficência Portuguesa de Porto Alegre for the presence / degree of PBE and data was statistically correlated with the parameters of the patient. PBE was present in 70.1% of patients. Tumors with higher volume had more PBE. Tumors of the olfactory groove showed more PBE than sphenoid wing and parassagittal tumors. Transitional subtype showed more PBE than fibroblastic and meningothelial subtypes.

Erratum to “Evaluation of the Expression of C-Kit (CD117) in Ependymomas and Oligodendrogliomas”

We came through this erratum and declare that we are aware that the author Ligia Maria Barbosa Coutinho, Professor at the Graduate Program in Pathology of Universidade Federal de Ciencias da Saude de Porto Alegre (UFCSPA), Brazil, was a part of the implementation of this paper, and, by our mistake, was absent from the list of authors. We would like to add Ligia Maria Barbosa Coutinho as a coauthor.

Effect of N-acetylcysteine on vasospasm in subarachnoid hemorrhage

Vasospasm remains an extremely serious complication that affects patients presenting with subarachnoid hemorrhage (SAH) due to ruptured intracranial aneurysms. The current therapeutic armamentarium is still insufficient in many cases, and the search for new therapies is necessary. In this study, we evaluated the effect of N-acetylcysteine (NAC) on cerebral arterial vasospasm using an experimental model. Twenty-four wistar rats were divided into 4 groups: [1] Control, [2] SAH, [3] SAH+NAC and [4] SAH+Placebo. The experimental model employed double subarachnoid injections of autologous blood. The proposed dose of NAC was 250 mg/kg intraperitoneally per day. We analyzed the inner area of the basilar artery to assess the action of NAC. The experimental model proved to be very adequate, with a mortality rate of 4%. The inner area of the basilar artery in the SAH group showed significant difference to the control group (p=0.009). The use of NAC significantly reduced vasospasm as compared to the untreated group (p=0.048) and established no significant difference to the control group (p=0.098). There was no significant improvement with the administration of placebo (p=0.97). The model of the dual hemorrhage proved to be very useful for vasospasm simulation, with overall low mortality. The administration of NAC significantly reduced vasospasm resulting from SAH, and may represent a new therapeutic alternative.

Acidente vascular cerebral: análise de 190 casos autopsiados

A retrospective study of 190 postmortem examinations of cerebrovascular disease from the Department of Pathology was carried out. We found 94 cases (49.47%) of hemorrhage, 67 (35.26%) of infarction and 29 patients (15.26%) with hemorrhage and infarction; both were more frequent in males. Among the hemorrhagic cerebral vascular disease the intracerebral hemorrhage was more frequent. The cerebral infarction was more frequent in the territory of the middle cerebral artery. Arterial hypertension was the most common cause of cerebral hemorrhage and the cause in the great majority of the cerebral infarction cases was atherosclerosis.Foram estudados 190 casos de AVC autopsiados no Departamento de Patologia da Fundacao Faculdade Federal de Ciencias Medicas de Porto Alegre, tendo sido encontrados 94 (49,4%) casos de hemorragia, 67 (35,26%) de infartos e, em 29 (15,26%) casos, observou-se associacao de hemorragia e infarto. Tanto os infartos quanto as hemorragias foram mais frequentes em homens que em mulheres. As medias de idade foram 34,9 anos para as hemorragias e 48,6 anos para os infartos. Dos AVC hemorragicos, a variedade intraparenquimatosa foi a mais frequente. Os infartos predominaram em territorio da arteria cerebral media. As causas determinantes de hemorragia foram principalmente a hipertensao arterial sistemica e processos infecciosos. No grupo dos infartos, a aterosclerose predominou.

Histoplasmomas encefálicos múltiplos: estudo autópsico de um caso

Report of the case of a 28-years-old black woman who developed changes in behavior followed by neurological alterations. The CT scans of the brain revealed multiple calcified granulomas. The patient died and the autopsy showed granulomatous lesions with central caseation in the brain. Microscopical examination disclosed numerous Histoplasma capsulatum. This is the first case of histoplasmoma of the brain described in Brazil.

Metástase de carcinoma de mama na hipofise: relato de um caso

E relatado o caso de paciente feminina de 65 anos de idade que apresentou sintomatologia neurologica com evolucao de um mes, com progressao rapida para a morte. A autopsia demonstrou a presenca de metastases cerebrais, multiplas, cerebelares, de tronco cerebral e de hipofise, bem como metastases para a glândula tireoide e supra-renais. Os autores discutem a frequencia de metastases na hipofise, especialmente nos casos de carcinoma de mama. Alem disso tecem consideracoes a respeito da localizacao da metastase na hipofise e seu aspecto macro e microscopico.

Tuberculose meningo-encefalica na infância: estudo anatomo-patologico de 10 casos

The anatomo-pathological study of ten cases of tuberculosis of the central nervous system (CNS) in children under 10 years old is reported. The emphasis is given to the macroscopic and microscopic changes produced by the tuberculosis in the meninges, in the nervous parenchyma and in the vessels. The clinical and pathological findings are discussed and correlated with the literature. The authors concluded that: 1) the lesion in children with tuberculosis of the CNS is generally a proliferative meningoencephalitis; 2) the nervous parenchyma may be affected by the contiguous propagation of the tuberculous process or by the circulatory changes secondary to the arterial lesions; 3) because of the localization of the endocranial vessels in the sub-arachnoidal space they are generally injured by the inflammatory process, which can determine an obliterating endarteritis, which can be observed by a carotid angiography.