This report concerns a 64-year-old woman with a lymphoplasmacyte-rich meningioma. Radiographically and macroscopically, the tumor had the appearance of an ordinary meningioma. Components of the meningothelial cells were positively immunostained for epithelial membrane antigen. The results of immunohistochemical assays with the antibodies to surface markers of lymphocytes L26 and UCHL-1 indicated that the lymphoplasmacellular proliferation was not neoplastic but probably represented an immune reaction of the host.
Ion exchange and chelate properties of poly(ethyleneimine) resin (PEI) were studied. Adsorption of neucoccin anions (NC−) (maximum 1.7×10−4 mol/g) was greater than that of Crystal Violet cations (CV+) (maximum 0.17×10−4 mol/g), indicating that PEI is an anion exchanger. CV+ adsorption increased with the addition of sodium polyacrylate due to its bridging action between CV+ ions and PEI. Adsorption of CrO42− was confirmed to be much greater than that of NC− ions amounting to 4×10−3 mol/g at a sufficiently concentrated solution of CrO42−. The acid exchange capacity of PEI was found to be about the same as the maximum amount of adsorption of CrO42−. Kinetics of adsorption of CrO42− by PEI was studied at various temperatures. Adsorption followed a bimolecular reaction. Activation energy of 28.03×103 J/mol obtained is a right order of magnitude as an ion exchange adsorption. Chelating adsorption of Fe3+ and Cu2+ ions by PEI studied, the maximum amounts of adsorption being 3.1×10−3 mol/g and 3.3×10−3 mol/g, respectively. The values are greater than those for other synthetic polyethylene polyamine. PEI can be used as an anion and metallic cation adsorbent.
We report a case of intracranial germ cell tumor that showed pathological changes from neurohypophyseal germinoma to mixed germ cell tumors consisting exclusively of undifferentiated sarcomatous component after radiochemotherapy. Three surgical specimens and autopsied brain from the patient were histologically examined. An initial specimen from the neurohypophyseal tumor was diagnosed as germinoma with a two-cell pattern. Five years later, after repeated radiochemotherapy, the second specimen resected from the right temporal lobe showed mixed germ cell tumors consisting of the three components of germinoma, choriocarcinoma, and immature teratoma. Six months later after intensive radiotherapy, the right temporal tumor recurred and was surgically removed. The histological diagnosis was mixed germ cell tumors with abundant immature teratoma component. The patient died of uncontrollable tumor growth with repeated intratumoral hemorrhages. The autopsied brain showed sarcoma with angionecrosis. This pathological alteration indicated an increase in the sarcomatous component after undergoing various treatments. We discuss the histological changes of intracranial germ cell tumor modified by treatment.
Neuroendocrine tumors (NETs) are neoplasms that originate from cells of the endocrine and nervous systems, and are commonly found in the gastrointestinal and respiratory tracts. Primary intracranial NETs are extremely rare and have been the focus of only a few studies thus far. Herein, we report the case of a primary intracranial NET of the skull base complicated with tension pneumocephalus after radiotherapy. An 84-year-old woman visited a local hospital for a head injury, and CT revealed a skull base tumor. MRI showed that the tumor was located mainly on the clivus and extended into the paranasal sinuses and nasal cavity. We biopsied the tumor via the nasal cavity, and the pathological diagnosis was NET, WHO grade 2. We subsequently administered focal intensity-modulated radiation therapy, but the patient developed tension pneumocephalus 1 year after radiotherapy. We therefore performed endoscopic transnasal cerebrospinal fluid leak closure with a nasoseptal flap. The postoperative course was successful, and the patient returned home but died of an unknown cause 2 years after discharge. The optimal postoperative management of primary intracranial NETs remains controversial. Tension pneumocephalus related to radiotherapy is a rare complication. Assessing skull bone erosion before radiotherapy and performing regular radiological follow-up examinations are essential to prevent this rare complication.
Objective: Transarterial embolization (TAE) using liquid embolic material is adopted in the treatment of dural arteriovenous fi stulas (DAVFs) with direct cortical venous drainage or in patients in whom transvenous access is limited. Arresting fl ow by wedging a microcatheter tip into a main feeding vessel is important to achieve complete obliteration of DAVF with TAE. The Masamune catheter is a double lumen microcatheter with a silicone balloon at its distal end, characterized by the shortness of its catheter tip to the distal balloon end. Two cases of DAVF treated by TAE with the balloon fl ow arrest technique using a Masamune balloon microcatheter are reported. Case Report: Case 1, a 50-year-old man, was incidentally diagnosed with a tentorial DAVF with direct cortical venous drainage. An infl ated Masamune balloon catheter was wedged in the occipital artery, and trans-arterial embolization was performed under a fl ow-arrested condition. As preparative embolization of the other minor feeding arteries had not been performed, complete obliteration of DAVF was not achieved by competing fl ow. Case 2, a 64-year-old man, was diagnosed with a left transverse-sigmoid DAVF on angiogram. The DAVF was completely obliterated with the balloon fl ow arrest technique using liquid embolic material. Conclusion: The Masamune catheter can easily achieve an artificial flow-arrest condition by inflation of its distal balloon to prevent fragmentation of liquid embolic material. In conjunction with preparative embolization of minor feeding vessels, curative embolization may be achieved from a main feeder using this catheter.
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