bromochloroacetic-acid and Ependymoma

Extraneural ependymomas are rare tumors that occur in sacrococcygeal, pelvic and extra pelvic regions. While sacrococcygeal extraneural ependymomas are equally distributed among males and females, pelvic and extra pelvic ependymomas have been exclusively reported in women, mainly of child bearing age. We present a case of extraneural, pelvic ependymoma that showed clinical response to GnRH therapy with its immunohistochemical and electron microscopic analysis, and an overview of primary extraneural ependymomas based on a review of all such cases published in English literature.

Topics: Adult; Antineoplastic Agents, Hormonal; Cadherins; Ependymoma; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Leuprolide; Magnetic Resonance Imaging; Microscopy, Electron; Pelvis; Receptors, Androgen; Receptors, Estrogen; Receptors, Progesterone; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography

Clear cell meningioma (CCM) is a rare variant of meningioma, which is important to distinguish because of its aggressive behaviour. Sixty-eight cases have been previously described in the literature. In this retrospective study, we report seven cases of CCM operated in our institution between 1994 and 2008.. Seven CCM cases were retrieved from the files of our pathology department. Clinical and radiological data were reviewed. A standard histological study was realized and immunohistochemistry was performed with epithelial membrane antigen (EMA), cytokeratin KL1, progesterone receptors, Ki-67 (MIB-1), S100 protein.. Patients' age ranged from 2 to 70 years (median age: 36 years), with a female predominance (5/7 patients). Three patients belonged to the same family, probably affected by neurofibromatosis type 2. CCM occurred in various locations: medullary region (two), sphenoid wing (two), ponto-cerebellar angle (two), tentorium (one). The tumour could be fully resected in three cases. Follow-up ranged from 3 months to 15 years: recurrence occurred in four patients, three of whom eventually died from the disease.. In our series, the frequency of CCM (0,6% of all meningiomas operated on in our institution) and its histological aspects are almost identical to those observed of the literature. We discuss the predictive value of proliferation index (MIB-1) and the role of patient status and quality of surgical resection in the evolution.. Our study supports the fact that MCC course is less favourable than meningioma WHO grade I, even in the absence of anaplastic area, high mitotic activity, or necrosis. In this series, MIB-1 index was of no interest identifying patients with or without recurrence.

Topics: Adult; Aged; Astrocytoma; Biomarkers, Tumor; Child, Preschool; Diagnostic Errors; Ependymoma; Female; Humans; Keratins; Ki-67 Antigen; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Mucin-1; Neoplasm Proteins; Neurofibromatosis 2; Receptors, Progesterone; Retrospective Studies; S100 Proteins; Young Adult

We have studied an unusual, spontaneous, intradural extramedullary spinal cord tumor in 12 dogs. Animals presented with paraparesis and ataxia early in life (11/12 ranged from 6 to 38 months of age) suggesting that these tumors may be congenital. Various breeds of dogs were represented with four cases in German Shepherds and three in retrievers; there was no sex predisposition. Post-mortem examinations revealed a single intradural mass consistently located between T10 and L2, which produced extensive compression of the spinal cord. Metastasis was never observed and significant pathological changes in other organs were lacking. Microscopic examination revealed solid sheets of ovoid to fusiform cells interspersed with areas of acinar and tubular differentiation. Some areas were rarified and focal squamous metaplasia was observed. Ultrastructural features included the presence of a continuous basal lamina, junctional complexes, microvilli and occasional cilia at the apices of acinar complexes. Immunocytochemical studies did not support a neurectodermal origin. At least 13 case reports of this entity have been previously published and have been designated ependymomas, medulloepitheliomas and neuroepitheliomas. A recent case was diagnosed as a nephroblastoma and we feel that this is an interesting and provocative diagnosis. These tumors could result from remnants of renal primordium which becomes trapped between the dura and the developing spinal cord. However, firm evidence of such a histogenesis is not yet at hand.

Topics: Age Factors; Animals; Dogs; Ependymoma; Female; Keratins; Male; Microscopy, Electron; Spinal Cord Neoplasms

To study the clinicopathologic features of papillary tumor of the pineal region (PTPR).. Three hundred and eighty six cases of pineal region and posterior third ventricle tumors, two newborn and two adult pineal glands were analyzed by HE, PAS and immunohistochemistry of 16 antibodies (EnVision method).. Five cases of PTPR were diagnosed with mixed papillary features and densely cellular areas, and included one recurrent case. In the papillary areas, the vessels were lined by one or several layers of cuboidal/columnar cells; the vessel wall was hyalinized. In the densely cellular areas, sheets or nests of tumor cells were seen. The tumor cells of these five cases were immunoreactive to CK, CK8/18, synaptophysin, MAP2, nestin, S-100, and vimentin. Four cases were immunoreactive to NSE and CgA; and 2 cases were immunoreactive to NF. All five cases were negative for EMA, CK5/6, CEA, and NeuN. Ki-67 labeling index ranged from 1% to 6%.Three patients were alive, and the recurrent one died.. PTPR occurs in patients with over a wide age range, from children to adults, and is more commonly found in male than female. PTPR is composed of both papillary and solid areas, characterized by epithelial cytology, and needs to be differentiated from ependymoma. PTPR may originate from the specialized ependymocytes of the subcommissural organ. The prognostic factors are early diagnosis, complete surgical resection and radiotherapy.

Topics: Adolescent; Adult; Brain Neoplasms; Carcinoma, Papillary; Child; Diagnosis, Differential; Ependymoma; Female; Humans; Immunohistochemistry; Keratin-18; Keratin-8; Keratins; Male; Microtubule-Associated Proteins; Nestin; Pineal Gland; Pinealoma; S100 Proteins; Synaptophysin; Tomography, X-Ray Computed; Vimentin; Young Adult

Chordoma originates from embryonic notochordal remnants in the midline along the spinal axis and is characterized by cords and lobules of neoplastic cells arranged within myxoid matrix. Because of histologic similarities with myxoid matrix and overlapping immunohistochemical profile, chondrosarcoma, myxopapillary ependymoma, and chordoid meningioma enter in the histologic differential diagnosis at this site. Therefore, the judicious use of a panel of selected immunostains is unquestionably helpful in diagnostically challenging cases. To find useful immunohistochemical markers for assisting in differential diagnosis between chordoma and other tumors with chordoid morphology, an immunohistochemical study using D2-40, epithelial membrane antigen (EMA), pan-cytokeratin (panCK), glial fibrillary acidic protein (GFAP), S-100 protein, galectin-3, neural cell adhesion molecule (NCAM), beta-catenin, E-cadherin, and carcinoembryonic antigen was performed on 14 chordomas, 7 chondrosarcomas, 9 myxopapillary ependymomas, and 4 chordoid meningiomas. Chordoma typically showed positive for EMA and panCK and negative for D2-40 and GFAP; whereas chondrosarcoma revealed positive for D2-40, and negative for EMA, panCK, and GFAP; myxopapillary ependymoma positive for GFAP and negative for EMA; and chordoid meningioma positive for EMA, and negative for panCK and GFAP. On the basis of our immunohistochemical study, a panel of D2-40, EMA, panCK, and GFAP allowed the correct recognition of all tumors examined. Other immunohistochemical markers including S-100 protein, galectin-3, NCAM, beta-catenin, E-cadherin, and carcinoembryonic antigen were of little value in differential diagnosis. In summary, the best immunohistochemical markers useful for the evaluation of tumors with chordoid morphology were D2-40, EMA, cytokeratin, and GFAP. D2-40 was a true chondroid marker to be useful for the differential diagnosis with chordoma.

Topics: Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Biomarkers, Tumor; Chondrosarcoma; Chordoma; Diagnosis, Differential; Ependymoma; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Meningioma; Mucin-1

The aim of this investigation was recognition of the epithelial differentiation and proliferative activity of ependymomas in the spinal cord compared with astrocytomas in the spinal cord and ependymoma in the brain. We investigated histopathological and immunohistochemical examination in thirty-five cases, including eleven ependymomas, thirteen astrocytomas in the spinal region and eleven ependymomas in the intracranial region. An anti-epithelial membrane antigen antibody (EMA), and two types of anti-cytokeratin antibodies, CAM 5.2 (45 and 52 kDa) and keratin (56 and 64 kDa) were applied as epithelial markers. The proliferative potential of the tumors was investigated using the Ki-67 labeling index (LI, %). Histologically, perivascular pseudorosettes were seen in all of the spinal and intracranial ependymomas. There were few ependymal structures in the spinal ependymomas except in the myxopapillary type. Immunohistochemical study demonstrated that nine (82%) were immunoreactive for EMA, eight (73%) were immunoreactive for CAM 5.2 and three (27%) were immunoreactive for keratin in the spinal ependymomas. In the spinal astrocytomas, no tumors were immunoreactive for EMA or CAM 5.2. One of thirteen cases was immunoreactive for keratin. The Ki-67 LI of the spinal ependymomas was lower than that of the intracranial ependymoma (p < 0.01). Epithelial differentiation was found in the ependymomas which may reflect the differences in histological and biological features between ependymomas and astrocytomas in the spinal cord. Regional differences in ependymomas may influence not only clinical features but also histo-pathological characteristics.

Topics: Adolescent; Adult; Aged; Cell Differentiation; Cell Division; Child; Child, Preschool; Ependymoma; Epithelium; Female; Humans; Immunohistochemistry; Infant, Newborn; Keratins; Ki-67 Antigen; Male; Middle Aged; Mucin-1; Spinal Cord Neoplasms

The morphologic distinction of ependymomas with epithelial cytology from metastatic carcinoma may pose a significant problem in differential diagnosis. The known presence of keratin in glioma cells further complicates the issue. Using the labeled streptavidin-biotin method with automated staining, we studied epithelial and glial marker expression in 52 ependymomas of varying type and grade, including 20 epithelial-appearing, 14 glial-appearing, eight mixed pattern, and 10 myxopapillary tumors; 38 were low grade and 14 anaplastic. All tumors were immunoreactive for glial fibrillary acidic protein (GFAP), and S-100 protein. Diffuse staining for GFAP was noted in glial-appearing ependymomas featuring perivascular pseudorosettes. Diffuse immunostaining for S-100 protein was seen in cellular lesions exhibiting epithelial-like features. Staining was more diffuse for GFAP than S-100 protein in anaplastic ependymomas. Keratin (AE1/AE3) reactivity was seen in 98% of cases, the pattern being similar to that of GFAP. The frequency of staining for other keratins varied: wide-spectrum keratin (35%), cytokeratin (CK)7 (20%), CAM 5.2 (19%), CK903 (14%), and CK20 (8%); as a rule, it was scant and limited to occasional cells and processes. epithelial membrane antigen (EMA) staining was seen in 36% of all cases and in 67% of epithelial-appearing tumors wherein it often high-lighted microlumina. Aside from AE1/AE3 staining and very infrequent wide-spectrum keratin and EMA reactivity, expression of epithelial markers was not seen in anaplastic ependymomas. No carcinoembryonic antigen (CEA) positivity was noted in any case. Collagen IV reactivity was limited to tumor cell-stroma interfaces. Although variable, S-100 protein and GFAP staining is seen in all ependymomas, particularly in true and perivascular pseudorosettes. Widespread reactivity for keratin AE1/AE3 corresponds closely to the pattern of GFAP staining. Significant staining for other keratins or for CEA is inconsistent with a diagnosis of ependymoma. EMA reactivity is largely limited to luminal staining of rosettes and tubules.

Topics: Biomarkers, Tumor; Carcinoma; Collagen; Diagnosis, Differential; Ependymoma; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Immunophenotyping; Keratins; Mucin-1; S100 Proteins

We describe two histologically unusual cases of ependymoma of the filum terminale. Both tumors occurred in 14-year-old boys. An intradural encapsulated mass attached to the filum terminale was demonstrated radiologically in both cases and totally resected at surgery. In case 1 the neoplasm was uniformly composed of pleomorphic giant cells and was without perivascular pseudorosettes or myxopapillary changes. Case 2 was a myxopapillary ependymoma with multiple foci of pleomorphic giant cells. Neither tumor had prominent mitotic activity, necrosis, or endothelial proliferation. Both tumors were immunopositive for cytokeratin and glial fibrillary acidic protein. Ultrastructural features included basal laminae, interdigitating cell processes, microvilli, cilia, intercellular junctions, and cytoplasmic intermediate filaments. Cytogenetic analysis in case 1 showed a hypodiploid karyotype with monosomy of chromosomes 1, 10, 14, 16, 20, and 22. We interpret both tumors as most consistent with a variant of ependymoma. Because of the unique gigantocellular light microscopic appearance of the entire tumor in case 1, we propose classifying this tumor as a new morphologic subtype: giant cell ependymoma of the filum terminale. The combination of gigantocellular and myxopapillary features in case 2 supports a histogenetic relationship between giant cell ependymoma and myxopapillary ependymoma.

Topics: Adolescent; Cauda Equina; Ependymoma; Giant Cells; Glial Fibrillary Acidic Protein; Glioma; Humans; Immunohistochemistry; Keratins; Male; Peripheral Nervous System Neoplasms

An immunohistochemical study of glial fibrillary acidic protein (GFAP), S-100 protein, cytokeratin (CKER), epithelial membrane antigen (EMA), and transthyretin (TTR) was carried out on 11 cases of choroid plexus papilloma (CPP) and 19 of ependymoma, using the peroxidase antiperoxidase technique. Among the 11 cases of CPP, all 11 were positive for CKER, EMA, and TTR, 10 for S-100 protein, and five for GFAP. Most of the GFAP-positive papilloma cells were simultaneously positive for CKER. However, these GFAP-positive cells were negative for TTR. Among the 19 cases of ependymoma, 16 were positive for GFAP, 17 for S-100 protein, three for CKER, eight for EMA, but none for TTR. Some GFAP-positive cells were also stained for CKER. However, TTR was not found in any of the ependymal cells. These findings suggested that CPP cells which show ependymal or glial differentiation lost the ability to synthesize TTR which is known to be synthesized in the epithelial cells of the choroid plexus. The more GFAP-positive cells present in a CPP, fewer TTR-positive cells are present. Though CPPs are usually easily distinguishable from ependymomas, occasional doubt arises concerning the differential diagnosis between CPP and papillary ependymoma. TTR can be a very useful diagnostic marker of CPP.

Topics: Adult; Biomarkers, Tumor; Child; Child, Preschool; Choroid Plexus Neoplasms; Diagnosis, Differential; Ependymoma; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Infant; Keratins; Male; Membrane Glycoproteins; Middle Aged; Mucin-1; Papilloma; Prealbumin; S100 Proteins

The pattern of basement membrane deposition was investigated in benign and malignant choroid plexus tumours using an immunocytochemical method to detect laminin, an intrinsic basement membrane component. The results were compared with intracranial ependymomas and myxopapillary ependymomas of the filum terminale. Expression of the intermediate filaments cytokeratin and glial fibrillar acidic protein (GFAP) and the epithelial marker carcino-embroyonic antigen (CEA) was also assessed. Laminin was detected in a subepithelial location in all the choroid plexus tumours but in none of the ependymomas, although basement membrane fragmentation was seen in the choroid plexus carcinomas. In contrast, GFAP was present in all the types of tumour examined. Cytokeratin (as detected by CAM 5.2) was present in all the choroid plexus lesions and also in the ependymomas arising in the spinal canal. CEA was not detected. We conclude that immunostaining for laminin assists distinction between choroid plexus tumors and papillary ependymomas and between benign and malignant choroid plexus tumours.

Topics: Basement Membrane; Cerebral Ventricle Neoplasms; Choroid Plexus; Ependymoma; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Laminin

An immunohistochemical study on ependymal tumours was performed in order to determine what relationships exist between histological subtypes and epithelial or glial characteristics. Thirty-eight ependymal tumours were examined with antibodies to cytokeratin (CK), epithelial membrane antigen (EMA), transthyretin (TTR) and glial fibrillary acidic protein (GFAP) using the avidin-biotin-complex technique. They included 23 ependymomas, 13 anaplastic ependymomas, and 2 myxopapillary ependymomas. Only 3 of the 23 ependymomas were positive with EMA but 19 reacted with GFAP. None of them were positive with CK. Six of the 13 anaplastic ependymomas were positive with EMA, 3 with CK and 10 with GFAP. Five of the 6 anaplastic ependymomas which had epithelial marker proteins were either negative or weakly positive for GFAP. The present study demonstrates that most benign ependymomas exhibit GFAP positivity while the anaplastic ones tend to suppress their glial nature in favour of epithelial differentiation. However, ependymal tumours showed few characteristics of choroid plexus cells; only one of the examined cases was positive for TTR.

Topics: Antigens, Neoplasm; Ependymoma; Epithelium; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Mucin-1; Neuroglia; Prealbumin

Reported in this paper is a case of a fetus delivered in the 24th week of pregnancy whose intracranial space was found to be almost totally filled up by a choroid plexus papilloma. Co-expression of vimentin and cytokeratin 8, 18 of the epithelium was immunocytochemically observed, as had been also described in normal fetal choroid plexus.

Topics: Adult; Cerebral Ventricle Neoplasms; Choroid Plexus; Ependymoma; Female; Fetal Diseases; Humans; Immunohistochemistry; Keratins; Pregnancy; Vimentin

Sixteen choroid plexus (CP) tumors in 12 male and four female adult dogs were analyzed microscopically. Tumors were in the lateral (six), third (six), and fourth (four) ventricles. The average age of the dogs was 6 years. Tumors were classified by the following criteria: 1) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma with atypical features (atypical CPP), which had increased cellular density, nuclear atypia, two to four mitoses per 40x microscopic field, necrosis, and infiltration of the brain parenchyma and/or leptomeninges; and 3) choroid plexus carcinoma (CPC), which had marked nuclear atypia, poorly formed papillae, greater than four mitoses per 40x microscopic field, abnormal mitotic figures, and/or extraneural metastasis. The 16 tumors were classified either as CPP or atypical CPP (none as CPC). Statistically significant associations between brain infiltration and necrosis and atypical CPP were identified. Immunohistochemical studies in 11 tumors demonstrated staining for keratin in three tumors, two of which also reacted with carcinoembryonic antigen (CEA). There was no immunoreactivity with glial fibrillary acidic protein or epithelial membrane antigen. Choroid plexus from one of three control dogs stained focally for cytokeratin only. It is concluded that normal choroid plexus and CP tumors in the dog express epithelial, but not glial differentiation.

Topics: Animals; Carcinoembryonic Antigen; Carcinoma; Cerebral Ventricle Neoplasms; Choroid Plexus; Dog Diseases; Dogs; Ependymoma; Female; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Male

Reported in this paper is a congenital ependymoma in an 23-week old foetus. The neoplasm was well vascularised and contained typical ependymal rosettes. The tumour cells did not react with GFAP-antiserum. They reacted weakly with neuron-specific enolase and vimentin and exhibited strong antigenicity with S-100-protein-antiserum. Cytokeratin antigen was recordable from some tumour cells. The tumour was sufficiently mature for classification as ependymoma. Immunohistochemical findings suggested possible ectodermal origin of the tumour cells.

Topics: Brain Neoplasms; Ependymoma; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Infant, Newborn; Infant, Premature; Keratins; Phosphopyruvate Hydratase; S100 Proteins; Vimentin

A case of malignant choroid plexus papilloma (choroid plexus carcinoma) originated in the third ventricle is reported. A 14-month old girl was admitted to our department with two-month history of impaired vision and gait disturbance. Neurological examination on admission disclosed a lethargy, blindness, and left hemiparesis. Computed tomographic (CT) scan and magnetic resonance imaging (MRI) demonstrated a large contrast-enhancing mass, approximately 5 cm in diameter, in the region of third ventricle, extending to the bilateral lateral ventricles. The patient had gross total removal of the tumor via lateral ventricle route, and received 40 Gy of postoperative radiation therapy. Light microscopically, the tumor was composed of epithelial cells showing both papillary and poorly differentiated pattern. There were considerable cellular pleomorphism, frequent mitoses, and occasional necroses. Immunohistochemically, anti-keratin antibody was detected within majority of neoplastic cells. Both neoplastic epithelial cells and stroma showed negative reaction to anti-GFAP antibody. Ultrastructurally, the shape of the nuclei varied from ovale to irregular with many indentations. The chromatin was clumped around the periphery of the nuclei. The neoplastic cells contained numerous free ribosomes, glycogen granules, and rough endoplasmic reticulum. The apical cell surfaces showed various size of club-like or roundish microvilli filled with glycogen granules, and rarely 9 + 2 cilia. Elongated junctional complexes were occasionally seen near the apical ends. The basal portions of the cells had a continuous basement membrane. These immunohistochemical and ultrastructural findings were comparable to the choroid plexus papilloma with malignant features.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Cell Nucleus; Cerebral Ventricle Neoplasms; Choroid Plexus; Ependymoma; Female; Humans; Immunoenzyme Techniques; Infant; Keratins; Microscopy, Electron; Microvilli

Twenty-six ependymal and 15 choroid plexus tumors were examined with monoclonal antibody against cytokeratin using the avidin-biotin-peroxidase complex (ABC) technique. Serial sections were examined with antisera to glial fibrillary acidic protein (GFAP). In five ependymal tumors (one ependymoma, two papillary ependymomas, and two primitive neuroectodermal tumors [PNET] with ependymal cells), a variable number of cytokeratin-positive cells were present. Most tumor cells (except two PNET) were positive with GFAP antisera. Many cytokeratin-positive cells were present in all choroid plexus tumors. GFAP-positive cells were present focally in six of 11 papillomas and in one of four carcinomas. Although their staining patterns and distribution were clearly different, focal coexistence of cytokeratin and GFAP was observed in six papillomas and two ependymal tumors. Thus, some ependymal tumors (especially papillary ependymomas and occasional PNET) and many choroid plexus tumors have demonstrable positivity with antibody to cytokeratin, suggesting a transitional cell type with features of both ependyma and choroid plexus.

Topics: Carcinoma; Cerebral Ventricle Neoplasms; Child; Choroid Plexus; Ependyma; Ependymoma; Glial Fibrillary Acidic Protein; Humans; Immunoenzyme Techniques; Immunohistochemistry; Keratins; Papilloma

The peroxidase anti-peroxidase technique was used for localization of glial fibrillary acidic protein (GFAP) and vimentin (VM) in 19 ependymal tumors in order to determine if a unique pattern of intermediate filament (IF) expression could be demonstrated. Cytokeratin (CK) immunoreactivity was examined in a subgroup of 7 tumors with papillary pattern. Nineteen non-ependymal neuroectodermal tumors were used as controls. Ependymomas, subependymomas and astrocytomas were positive for both IF. Oligodendrogliomas, oligodendroglial portions of mixed gliomas and the majority of medulloblastomas were negative for GFAP and VM. Areas of poor differentiation in all tumors demonstrated little expression of any IF. A composite ependymoma/choroid plexus papilloma showed the presence of GFAP, VM and CK in the papillomatous portion only. Four papillary ependymomas were negative for CK. This study emphasizes the parallel distribution of GFAP and VM in well differentiated ependymomas and other glial tumors and casts doubt upon the concept of VM as a marker for de-differentiation in neuroectodermal neoplasia.

Topics: Cytoskeleton; Ependymoma; Glial Fibrillary Acidic Protein; Glioma; Humans; Immunohistochemistry; Intermediate Filaments; Keratins; Vimentin

Topics: Ependymoma; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Mucin-1; Phosphopyruvate Hydratase

Sixteen choroid plexus tumors (CPTs) have been investigated for the localization of different immunocytochemical markers of epithelial and nonepithelial nature, namely, simple epithelial-type cytokeratins, vimentin, glial fibrillary acidic protein (GFAP), a panepithelial antigen defined by the lu-5 monoclonal antibody (lu-5 antigen), S-100 protein, and epithelial membrane antigen (EMA). Intermediate filament proteins have been identified in paraffin sections of 14 of 16 cases (87.5%). In all these tumors, cytokeratins and vimentin were constantly coexpressed by the neoplastic cells, in a manner similar to that of the cells lining normal choroid plexus. In 7 of these 14 cases, in addition to cytokeratins and vimentin, the neoplastic cells were shown to coexpress GFAP, which is not synthesized by their normal cell counterpart. The appearance of GFAP immunoreactivity in CPTs might be related to an ependymal differentiation of the neoplastic cells, because normal ependyma and ependymomas constantly coexpress GFAP and vimentin. The simultaneous expression of three distinct intermediate filament proteins by the same neoplastic cells is an exceedingly rare phenomenon, which has never been reported by double labeling technique in neoplasms of the central nervous system. Despite the complex antigenic profile of the CPT, which includes immunoreactivity for lu-5 antigen, S-100 protein, and EMA in most of the cases, positivity for three different epithelial markers indicates that these tumors have an epithelial nature. Moreover, the immunocytochemical typing of CPT with the panel of antibodies used in the current investigation allows differentiation from other primary and metastatic central nervous system tumors.

Topics: Antibodies, Monoclonal; Cell Compartmentation; Cerebral Ventricle Neoplasms; Choroid Plexus; Ependyma; Ependymoma; Epithelium; Humans; Immunologic Techniques; Keratins; Membrane Proteins; Mucin-1; S100 Proteins; Vimentin

Morphological features and immunoreactivity for cytokeratin (CK), glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) of three canine neuroepitheliomas and three canine ependymomas were investigated. Neuroepitheliomas were in three German shepherds as intradural-extramedullary solitary masses, with spinal cord displacement between T10 and L2. Histologically, they contained tubules and acini, lined by epithelial cells with focal squamous metaplasia, rosette-like structures, and polygonal to spindle-shaped cells between tubules. Acini were empty or filled with a homogeneous, eosinophilic periodic acid-Schiff (PAS)-positive material. Mitotic indices varied from low to moderate. Ependymomas occurred in the third (two cases) and fourth ventricle in adult boxers. Histologically, they were composed of cells with an ill-defined, scant amphophilic cytoplasm, with a central round euchromatic nucleus; cells formed pseudorosettes, with a central fibro-vascular stroma. Neuroepitheliomas stained for CK, but ependymomas did not. Both failed to stain for GFAP, NSE, or phosphotungstic acid hematoxylin (PTAH). Thus, antibodies to cytokeratin are useful to distinguish neuroepitheliomas from ependymomas.

Topics: Animals; Cross Reactions; Diagnosis, Differential; Dog Diseases; Dogs; Ependymoma; Glial Fibrillary Acidic Protein; Immunoenzyme Techniques; Immunohistochemistry; Intermediate Filaments; Keratins; Neuroectodermal Tumors, Primitive, Peripheral; Phosphopyruvate Hydratase; Spinal Cord Neoplasms

The intermediate filament protein types of normal choroid plexus and ependymal tissue and their putative tumors were investigated. In normal human choroid plexus tissue, but not in ependyma, keratin could be demonstrated immunohistochemically. By immunoblotting, keratins 8, 18, and 19 were found, but glial fibrillary acidic protein (GFAP) was absent. In mouse and rat, choroid plexus epithelium and ependymal lining cells were keratin-positive. In addition, many ependymal cells were vimentin-positive. Keratin was immunohistochemically found in three of four choroid plexus papillomas, two of two choroid plexus carcinomas, and the lining cells of three neuroepithelial cysts. GFAP-positive cells were present in some choroid plexus tumors. In contrast, none of the eight ependymomas contained keratin, but all were strongly positive for GFAP. The results show that choroid plexus lining cells and choroid plexus tumors have true epithelial characteristics in their cytoskeleton, in contrast to ependymomas, which do not show keratin positivity but show glial filaments, as would be seen in astrocytic tumors.

Topics: Adult; Animals; Antibodies, Monoclonal; Cerebral Ventricle Neoplasms; Child; Child, Preschool; Choroid Plexus; Ependyma; Ependymoma; Female; Fluorescent Antibody Technique; Humans; Infant; Intermediate Filament Proteins; Keratins; Male; Mice; Middle Aged; Rats

Six chordomas, nine chondrosarcomas, and three myxopapillary ependymomas of the filum terminale were evaluated immunohistochemically for the expression of intermediate filament proteins by the use of monospecific antibodies against intermediate filament proteins of keratin, vimentin, and glial fibrillary acidic protein (GFAP) type. All chordomas were positive for keratin but negative for GFAP, whereas chondrosarcomas and ependymomas were negative for keratin. Chondrosarcomas showed strong vimentin positivity, whereas ependymomas were positive for GFAP. Chordomas showed desmosomelike junctions by electron microscopy, whereas chondrosarcomas of different types showed no junctions or only primitive ones. By electron microscopy chordomas often showed prominent intermediate filaments also associated with desmosomes, and poorly differentiated chondrosarcomas also showed prominent intermediate filaments. Keratin positivity of chordomas suggests their epithelial nature, while vimentin positivity of chondrosarcomas is in line with their mesenchymal derivation. The results also show that antibodies against different intermediate filament proteins can be applied as diagnostic aids in making the distinction between chordomas, chondroid tumors, and ependymal tumors.

Topics: Adolescent; Adult; Aged; Antibodies; Chondrosarcoma; Chordoma; Cytoskeleton; Desmosomes; Diagnosis, Differential; Ependymoma; Glial Fibrillary Acidic Protein; Humans; Intermediate Filament Proteins; Keratins; Middle Aged; Vimentin