myelin-basic-protein and Medulloblastoma

The technical modalities of the immunohistochemical demonstration of antigens of neuroectodermal differentiation and of mesenchymal nature in neural tissue are discussed. On the main antigens (S-100 protein, GFAP, Vimentin, Neuronal specific Enolase, neurofilaments, myelin basic protein, carboanhydrase C, FVIII/RAg, laminin, fibronectin) the most important findings are described and critically considered. They are interpreted in the light of the present knowledge on the problems of differentiation of the oncotypes and on particular aspects of bio-pathology of brain tumors.

Topics: Astrocytes; Fixatives; Glial Fibrillary Acidic Protein; Glioma; Humans; Immunoenzyme Techniques; Laminin; Medulloblastoma; Myelin Basic Protein; Naphthol AS D Esterase; Neoplasms, Nerve Tissue; p-Dimethylaminoazobenzene; Staining and Labeling; Tyrosine 3-Monooxygenase; Vimentin

A 30-year-old man suffered for a year of a typical syndrome of cerebellar tumor. At suboccipital craniectomy a soft tumor infiltrating both hemispheres and vermis, filling up part of the IV ventricle was found. After subtotal removal of the neoplasm the postoperative course was poor and the patient died 5 weeks later. Biopsy material consisted of three types of tissue: 1. large nests of carrot-shaped, hyperchromatic cells, 2. fields of "halo" cells presenting myelin basic protein (MBP) immunoreactivity and 3. fields and scattered strongly GFAP-positive cells. The histological and immunocytochemical pattern of the neoplasm indicates differentiation of the tumor into oligodendrogliomatous and astrocytomatous line being an uncommon example of dual glial differentiation capability in medulloblastoma.

Topics: Adult; Astrocytoma; Cell Differentiation; Cerebellar Neoplasms; Fatal Outcome; Glial Fibrillary Acidic Protein; Humans; Male; Medulloblastoma; Myelin Basic Protein; Neoplasm Invasiveness; Oligodendroglioma

A case of cerebellar medulloblastoma with clusters of mature ganglion cells and glial cells is described. The patient, a 15-year-old girl, underwent three operations followed each time by radiation and chemotherapy during the four-year clinical course. Histologically, the ganglion cells were clearly identifiable by their abundant eosinophilic cytoplasm, round nuclei with prominent nucleoli, tigroid granules, and argyrophilic fibrils and axons. Immunohistochemically, the cells were NSE- and NF-positive, and ultrastructurally they contained abundant tubules and filaments, neurosecretory granules and well developed rough endoplasmic reticulum. There were many cells transitional in appearance between primitive cells and mature ganglion cells. The tumor also had many mature yet atypical astrocytes and oligodendrocytes. The exact mechanism of the extensive neuronal and glial maturation of medulloblastoma cells is unclear, but the repetitive surgical interventions, radiation and chemotherapy might have had certain cytostatic effects on rapidly dividing medulloblastoma cells, giving them a chance to mature into postmitotic cells with potential for neuronal and glial differentiation.

Topics: Adolescent; Cell Transformation, Neoplastic; Cerebellar Neoplasms; Female; Ganglia; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Intermediate Filament Proteins; Medulloblastoma; Microscopy, Electron; Myelin Basic Protein; Neuroglia; Phosphopyruvate Hydratase; S100 Proteins