Phenotypic and genotypic characterization of glioblastoma multiforme with epithelial differentiation and adenoid formations.

Rare examples of high-grade gliomas show focal epithelial differentiation, which may require distinction from colliision tumors. These epithelial constituents are not well-characterized immunophenotypically and have rarely been subjected to genotyping. We describe a case of a 54-year-old female with a short history of hemiparesis who was found to have an absolute lymphocytosis and a heterogeneously enhancing frontotemporal tumor.

October 2001: 40-year-old Xhosa male with back pain and leg weakness.

A 40-year-old Xhosa male presented with progressive upper lumbar back pain and weakness At examination he was emaciated and had enlarged lymph nodes in the groin and axilla. Both lower limbs were severely atrophic and weak. Sensation to touch and pain was decreased below L3 bilaterally.

Proton relative biological effectiveness (RBE) for survival in mice after thoracic irradiation with fractionated doses.

Purpose: This study aims at providing relative biological effectiveness (RBE) data under reference conditions accounting for the determination of the "clinical RBE" of protons.

Methods And Materials: RBE (ref. (60)Co gamma-rays) of the 200 MeV clinical proton beam produced at the National Accelerator Centre (South Africa) was determined for lung tolerance assessed by survival after selective irradiation of the thorax in mice.

Acute stroke in a child with miliary tuberculosis.

Neurological symptoms in childhood miliary tuberculosis are generally caused by underlying tuberculous meningitis (TBM), since the 2 conditions commonly occur concurrently. Cerebral infarction, a well-recognized complication of TBM, usually results from tuberculous periarteritis and secondary thrombosis. Neuropathological studies have demonstrated that the anterior cerebral circulation is more commonly affected than the arteries of the vertebro-basilar system, and basilar artery occlusion as a presenting manifestation of childhood miliary tuberculosis or TBM has not been described before.

Cerebral infarction and intracranial arterial dissection in closed head injury.

This report describes the autopsy findings in three cases of closed head injury dying of cerebral infarction, with brain swelling and herniation. In each instance the cause of the infarct was found to be subintimal dissection involving intracranial anterior circulation arteries. The autopsy findings underscore the value of histological examination of vessels that macroscopically appear thrombosed.

Semiquantitative postembedding characterization of intermediate filaments in central nervous system lesions using immunoelectron microscopy.

Standardized postembedding immunoelectron microscopy was performed to demonstrate glial fibrillary acidic protein (GFAP) and vimentin in individual intermediate filaments to determine the diagnostic value of demonstrating ultrastructural and immunophenotypic characteristics of intermediate filaments in routine brain biopsy specimens. Dual expression of GFAP and vimentin was observed in the astroblastoma and astrocytes of Alexander's disease. The antigen availability for vimentin, however, was too low to allow reliable assessment of the GFAP:vimentin ratio in individual intermediate filaments and/or filament bundles.

Pleural Mesocestoides and cardiac shock in an obese vervet monkey (Cercopithecus aethiops).

Only one case of infection by tetrathyridia larvae of the tapeworm genus Mesocestoides was detected in 416 necropsies of captive vervet monkeys (Cercopithecus aethiops). Two hundred nine larvae were distributed between both pleural cavities. Mass and size ranges of larvae were determined.

Medicolegal aspects of cerebral amyloid angiopathy. A case report.

Autopsy examination performed on a 75-year-old woman who had been in a minor road traffic accident revealed an occipital lobar hematoma with subdural extension. Histological examination of brain tissue showed the presence of severe cerebral amyloid angiopathy. Diagnostic techniques and correlation and interpretation of these findings are discussed.

Shotgun pellet embolism to the brain.

This report describes the autopsy findings in a young man who died after having been shot with a shotgun from about 30 m. Although not suspected clinically, a right middle cerebral artery territory infarct was found; its cause was shown to be a shotgun pellet embolus that had lodged just proximal to the trifurcation of the right middle cerebral artery. The case underscores the importance of performing a thorough postmortem examination, including a careful study of cerebral vasculature, in instances of brain infarction.

Alexander's disease: a case report with brain biopsy, ultrasound, CT scan and MRI findings.

Alexander's disease is reported in a 6-month-old infant. The clinical course was characterized by hydrocephalus, irritability and psychomotor retardation, with subsequent seizures and spasticity. Findings on ultrasound examination, computerized tomography, magnetic resonance imaging and brain biopsy are presented.

Lafora-body disease with optic atrophy, macular degeneration and cardiac failure.

A 17-year-old boy was admitted to hospital in acute cardiac failure and psychosis. The clinical course, EEG records and tissue diagnosis, including biopsies of brain, skin, skeletal muscle, peripheral nerve and liver were compatible with Lafora-body disease (LBD). Unusual features were those of optic atrophy and macular degeneration, signs generally regarded as negative criteria for the diagnosis of this disease.

Chordomas--ultrastructure and immunohistochemistry: a report based on the examination of six cases.

Six chordomas (three classic and three chondroid) were examined ultrastructurally and with a panel of monoclonal antibodies. The three classic tumours showed the presence of desmosomes and intermediate filaments on electron microscopy, findings which gave a direct positive correlation when the tumours were stained with monoclonal antibodies against low molecular weight cytokeratin proteins. These results suggest that chordomas are essentially epithelial neoplasms and underline the fact that monoclonal antibodies to cytokeratins cannot be used in the differential diagnosis of classic chordoma vs carcinoma.

Microcystic meningiomas.

Four patients (two male and two female) underwent surgery for the removal of tumors with clinical and radiographic features typical of a meningioma. Despite an incorrect intraoperative frozen section diagnosis in two cases, the tumors were totally resected because the surgeon was convinced of the meningiomatous nature of the lesion. Subsequent histology revealed features of a microcystic meningioma and careful scrutiny of paraffin sections showed that each of the tumors contained occasional typical meningothelial cellular whorls which were a helpful diagnostic clue.

Xanthogranuloma of the choroid plexus of lateral ventricle, presenting with parosmia and parageusia.

Xanthogranulomas of the choroid plexus are usually asymptomatic. We present a short case report of a 60-year-old male whose symptoms of parosmia and parageusia have been relieved following surgical removal of a xanthogranuloma situated in the right lateral ventricle. Previous case reports and correlation of symptomatology and pathology are discussed.

Malignant glioma following radiotherapy for unrelated primary tumors.

Four cases are documented where a glioma was histologically verified in the irradiation field of a previously treated malignancy of a different cell line. Radiation-induced neoplasia in the central nervous system now has been established in the induction of meningioma and sarcoma. The association between therapeutic irradiation and glioma in the reported cases lends to the evidence that a causal relation does exist.

Amoebic meningo-encephalitis due to a free-living amoeba. A case report.

A 47-year-old man developed an undiagnosed encephalitic illness and died within 12 days. Autopsy showed focal granulomatous lesions associated with a necrotizing vasculitis. Light microscopy revealed the presence of free-living amoebae morphologically resembling Acanthamoeba species.

Autopsy-confirmed multiple sclerosis in a white South African. A case report.

The clinical and autopsy findings of a 31-year-old white South African woman with multiple sclerosis are described. Diagnostic, epidemiological and therapeutic aspects are discussed.

Pineal tumours at Groote Schuur Hospital, 1976-1984.

Since 1976, surgical approaches to the pineal region have been undertaken at Groote Schuur Hospital. Thirty cases presenting with a clinical and investigative diagnosis of pineal tumour have been reviewed with respect to epidemiology, surgery, histological subtypes and metastatic pattern. The postoperative management with radiotherapy in the different histological subtypes is discussed.

Metastasizing pineal germinoma. A case report and review.

A patient with biopsy-proven pineal germinoma was treated successfully by craniospinal irradiation. Lung and hilar node metastases developed 22 months after therapy. These were subtotally resected and further cis-platinum, vinblastine and bleomycin chemotherapy given with control 8 months later.

Epsilon-aminocaproic acid-induced myopathy. A case report.

The prolonged administration of epsilon-aminocaproic acid (EACA) resulted in the development of severe proximal myopathy associated with high plasma creatine kinase values, rhabdomyolysis, myoglobinuria, and mild hyperbilirubinaemia. Withdrawal of the drug led to spontaneous resolution of the clinical and biochemical syndrome. Structural and enzyme studies of a biopsy specimen of the involved skeletal muscle supported the presence of subclinical myopathy.

Cerebrotendinous xanthomatosis: a defect in cellular sterol biosynthetic control.

A mentally retarded woman with tendon xanthomata and normal serum cholesterol concentration was found to have raised cholestanol concentrations in the serum and in a xanthoma. This confirmed the diagnosis of cerebrotendinous xanthomatosis (CBX). No specific lipoprotein fraction was found to transport cholestanol.

Cutaneous leishmaniasis in Southern Africa. A case report.

The microscopical findings in a case of cutaneous leishmaniasis from South West Africa are presented in order to highlight the pathology of this disease and facilitate its recognition, should unsuspected cases occur in the Republic of South Africa. In addition, the ultrastructural findings confirm the presence of typical Leishmania which occur in the cytoplasm of macrophages where they are undergoing destruction. This adds a further dimension to the characterization of this disease in southern Africa.