Differentiation in the medulloblastoma. A histological and immunohistochemical study.

摘要: The histological and immunohistological features of medulloblastomas were investigated in patients participating an ongoing cooperative study the Societe International d'Oncologie Pediatrique (SIOP). Of 51 neoplasms, four classic desmoplastic variant. In regard to used grade considerable inter- intratumoral variation was observed. neoplasms with most pleomorphic coarsely structured nuclei tended be neuroblastic, whereas delicate uniform found neoplasms. Twenty-one cases exhibited neuroblastic differentiation form rosettes. these, three also contained neoplastic ganglion cells. five that calcified, rosettes accord tendency for calcification many islands markedly neuronspecific enolase (NSE)-positive cells seen. Although limited specificity this marker enzyme is recognized, we believe focal intense staining could indicate neuronal somewhat more advanced than small NSE-positive reduced cellularity, which strongly positive. these island usually larger vesicular those surrounding densely cellular areas. These frequent association Homer-Wright suggest foci represent a differentiation. Astrocytic difficult define required use glial fibrillary acidic protein (GFAP). Six GFAP-positive clearly neoplastic. Many others scattered reactive astrocytes dispersed whose versus nature not defined. Foci oligodendroglial appearance seen nine cases, but elsewhere raises issue as foci. Neoplasms ependymal results confirm medulloblastoma heterogeneous tissue pattern ‘malignancy’. differentiation, along lines predominant, readily recognized standard sections, frequently obvious throughout lesion, occasionally associated maturation mature on other hand, requires immunohistochemistry, often distinguish from gliosis, and, number seen, did demonstrate spectrum well-differentiated astrocytes.