A clinicopathologic and immunomorphologic study of 13 cases of ganglioglioma

Article Abstract:

Ganglia are clusters of nerve cells outside the central nervous system. However, brain tumors may be observed in which some of the cells have structures reminiscent of ganglion cells. Other cells in the same tumor have the appearance of glial cells, and thus these tumors are termed gangliogliomas. Although such tumors are rare, they are recognized as a distinct type of brain tumor. The typical ganglioglioma patient is young. Although the tumor may occur from infancy to old age, 80 percent of patients are under 30. Ganglioglioma may occur in many different places within the central nervous system, but the most common site is the cerebral hemispheres. As a result, partial seizures are the most common first symptom by which the ganglioglioma reveals its insidious presence. A study was conducted in which specific antibodies were used to identify the presence of various nervous system proteins in a sample of 13 gangliogliomas. Of the substances tested, synaptophysin proved to be the most accurate indicator of tumorous ganglion cells within the ganglioglioma. Synaptophysin is a protein found in the membranes of clear synaptic vesicles, the small sacks of neurochemicals released as a part of normal synaptic transmission. Synaptophysin is thought to play a role in release of these vesicles in response to calcium changes within the nerve cell. In the present study, synaptophysin could be found in all the specimens studied; in nine specimens it was found only in the cell surface, in two it was found only in the cell bodies, and in two it was found in both the cell bodies and the cell surface. Other substances found in some gangliogliomas included neurofilament peptides, chromogranin A, dopamine beta-hydroxylase, and tyrosine hydroxylase. No correlation was found between any of these substances and survival. However, ganglioglioma is an especially slow-growing tumor, and even when it appears to be completely removed it may recur after as long as 20 years. The slow growth rate of the ganglioglioma is why it is often better to leave a portion of this tumor in the brain after surgery than attempt a complete removal, which might seriously damage critical areas of the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Gliomas, Brain tumors

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The role of the pathologist in breast cancer management

Article Abstract:

When mastectomy was the treatment for all breast cancers, the primary job of the pathologist was to pronounce ''malignant'' or ''benign''. Now, however, the pathologist plays a more significant role, as the precise evaluation of a biopsy specimen is an important factor in determining the optimal mode of treatment. There is a growing propensity to use the TNM system to assign a stage to a malignant specimen, rather than vague terms such as ''minimal''. ( In TNM terminology, T refers to tumor extent, N to nodal metastases, and M to metastases to distant sites.) For the ''T'' in TNM, the pathologist must clearly distinguish, for example, between a carcinoma in situ and another carcinoma that may be smaller, but may have already begun to invade surrounding breast tissue. While the presence of metastases to the axillary lymph nodes (under the arm) is the single most important prognostic factor, it is also important for the pathologist to identify the histologic type of the cancer, as different types carry a different prognosis and require different treatment. The majority, 65 to 70 percent, of all breast cancers are infiltrating ductal carcinomas, not otherwise specified (NOS). Some breast cancers, such as mucinous, tubular, papillary, and adenoid cystic cancers have a prognosis more favorable than infiltrating ductal carcinoma, NOS. Others, such as inflammatory breast cancers, have a worse prognosis. As new techniques become available, such as DNA analysis, analysis of hormone receptors, and analysis of oncogene activity, the pathologist will likely acquire even greater responsibility for the evaluation of a biopsy specimen, so that therapeutic decisions can be made with the greatest amount of information available. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Breast cancer, Histology, Pathological, Pathological histology, Pathology

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