A marker for primary choroid plexus neoplasms.

Primary choroid plexus (CP) tumors are rare neoplasms that present in childhood or, less frequently, in adult life. The majority are benign and amenable to complete surgical excision, but occasionally more invasive variants are encountered. Although generally pathologically distinct, occasionally primary CP neoplasms may be difficult to distinguish from metastatic papillary carcinomas or papillary ependymomas. Conventional cytologic markers are not sufficiently specific to permit accurate diagnosis of primary CP tumors. The authors have reported that the CP is the unique site of synthesis within the brain of transthyretin (TTR, prealbumin), a transport protein for thyroxine and retinol. They therefore investigated the utility of TTR as a biochemical marker for CP tumors. They detected intense immunoreactivity for TTR at high dilutions of primary antiserum in the neoplastic epithelium of all of nine primary CP tumors (six papillomas and three carcinomas), but not in eight cellular or three papillary intracerebral ependymomas, meningiomas, oligodendrogliomas, astrocytomas, primary extracerebral papillary carcinomas (three thyroid, two breast) or five of six cerebral metastases from systemic papillary carcinomas. In one case of cerebral metastasis from papillary thyroid carcinoma, rare isolated immunoreactive cells were observed. Faint staining of the stromal-ependymal junction was seen in myxopapillary ependymomas of the filum terminale, which were otherwise nonreactive. By in situ hybridization, TTR mRNA was abundant in neoplastic CP epithelium, confirming local TTR synthesis. The authors conclude that TTR is synthesized by neoplastic CP epithelium and is an excellent marker for primary CP neoplasms.

[Immunohistochemical study on distribution of transthyretin in normal human brain tissue and tumors].

Immunohistochemical examination of transthyretin (TTR), which is known to be synthesized in the epithelial cells of the choroid plexus as well as in the liver cells, was carried out on normal brain tissues and 84 human brain tumors, using a peroxidase-antiperoxidase (PAP) technique. TTR was demonstrated diffusely and strongly in the cytoplasm of normal choroid plexus cells, but not in ependyma and other tissues of normal brain. In all of 10 choroid plexus papillomas, TTR was found within the cytoplasm of tumor cells. In contrast, neither the two papillary ependymomas nor any other brain tumors contained TTR. Among the choroid plexus papillomas, some cases showed clear positive reactions in almost all tumor cells, while others had only a few TTR-positive cells. With these immunohistochemical findings, TTR proved a very useful marker of normal choroid plexus and choroid plexus papilloma.

Cellular gene expression in papillomas of the choroid plexus from transgenic mice that express the simian virus 40 large T antigen.

Transgenic mice that contain the simian virus 40 (SV40) enhancer-promoter and large tumor (T) antigen gene develop papillomas of the choroid plexus. The tumors remain well differentiated on histological examination and express normal levels of tissue-specific mRNAs for transthyretin (TTR) and the 5-HT1C serotonin receptor, two differentiated cell markers. Both Northern (RNA) blot analysis and in situ cytohybridization have been used to monitor the steady-state levels of the mRNAs from the viral oncogene (T antigen) and from several cellular oncogenes. In situ hybridization demonstrated, in serial sections, increased levels of both T antigen mRNA and p53 mRNA localized in the tumor tissue but not in the normal brain tissue. The ratios of the steady-state levels of mRNA for p53/TTR and p53/L32, a ribosomal protein gene, were 2- to 20-fold higher in the tumor tissue than in the normal choroid plexus tissue. Several other oncogenes did not show elevated levels of mRNA in these tumors. p53 protein levels were not detectable in normal brain tissue, but p53 levels were very high in tumor tissue in which all of the p53 was found in a complex with the SV40 large T antigen. These data continue to show a close relationship between SV40 T-antigen-mediated tumorigenesis and the role of p53 in these tumors.

A histologic and immunocytochemical study of choroid plexus tumors of the dog.

Sixteen choroid plexus (CP) tumors in 12 male and four female adult dogs were analyzed microscopically. Tumors were in the lateral (six), third (six), and fourth (four) ventricles. The average age of the dogs was 6 years. Tumors were classified by the following criteria: 1) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma with atypical features (atypical CPP), which had increased cellular density, nuclear atypia, two to four mitoses per 40x microscopic field, necrosis, and infiltration of the brain parenchyma and/or leptomeninges; and 3) choroid plexus carcinoma (CPC), which had marked nuclear atypia, poorly formed papillae, greater than four mitoses per 40x microscopic field, abnormal mitotic figures, and/or extraneural metastasis. The 16 tumors were classified either as CPP or atypical CPP (none as CPC). Statistically significant associations between brain infiltration and necrosis and atypical CPP were identified. Immunohistochemical studies in 11 tumors demonstrated staining for keratin in three tumors, two of which also reacted with carcinoembryonic antigen (CEA). There was no immunoreactivity with glial fibrillary acidic protein or epithelial membrane antigen. Choroid plexus from one of three control dogs stained focally for cytokeratin only. It is concluded that normal choroid plexus and CP tumors in the dog express epithelial, but not glial differentiation.

Transthyretin immunoreactivity in human and porcine liver, choroid plexus, and pancreatic islets.

We examined transthyretin immunoreactivity (TTR-IR) in human and porcine liver, choroid plexus, and pancreatic islets with both polyclonal and monoclonal antibodies to TTR. The specificity of the immunoreactions and the effects of various fixatives were tested in immunohistochemical and dot-blot systems. B-5 fixative (mercuric chloride and sodium acetate in formalin) was the best immunopreservative. In both species, the TTR-IR in choroid plexus epithelial cells was strong and was much greater than that in hepatocytes. Glucagon cells in pancreatic islets were also strongly TTR immunoreactive. Insulin cells were slightly TTR immunoreactive in human but strongly so in porcine pancreas. The finding of TTR-IR in normal islets explains the presence of TTR-IR in human endocrine pancreatic tumors, notably glucagonomas and malignant insulinomas.

Distribution of insulin-like growth factor II receptor immunoreactivity in rat tissues.

Antibodies specific for the insulin-like growth factor II (IGF-II) receptor were used to study its distribution in a number of rat tissues and cell lines in order to determine which cells might be responsive to local or circulating IGF-II. In cultured 18-54,SF and B104 neuroblastoma cells, plasma membrane and cytoplasmic staining corresponding to Golgi apparatus could be seen, consistent with the glycoprotein nature of this receptor. Antibody binding was also seen in the central nervous system, confined primarily to the choroid plexus, and the vascular and ependymal elements. Some staining was seen in the parenchyma of the brain, in addition to binding around nerve sheaths and axon bundles. There were high levels of immunoreactivity in all three lobes of the pituitary, including vascular and cellular elements. In liver, highest levels of immunoreactivity occurred in the sinusoidal cells. In lung, IGF-II receptor immunostaining was seen in the alveoli and around the bronchioles. Staining in kidney was observed in glomeruli, tubules, and Bowman's capsules. Lower levels of immunostaining were seen in skeletal muscle, located primarily around the muscle sheaths. Localization of IGF-II receptor to cells of known function in different tissues will help elucidate the role of this ligand-receptor system in regulating growth and metabolism.

An immunohistochemical study of cytokeratin and glial fibrillary acidic protein in choroid plexus papilloma.

Cellular localization of cytokeratin and glial fibrillary acidic protein (GFAP) was examined in two normal choroid plexuses and five choroid plexus papillomas by the peroxidase-antiperoxidase (PAP) method and double immunofluorescence (IFL) microscopy. Cytokeratin was observed in the majority of epithelial cells in all samples of normal and neoplastic choroid plexuses. On the other hand, GFAP was observed in some of the constituent epithelial cells in two cases of papilloma. Most of these GFAP-positive papilloma cells were simultaneously positive for cytokeratin, as could be seen by the PAP stainings of serial sections and by the double IFL stainings of the same sections. From these findings, it was suggested that normal and neoplastic choroid plexus epithelial cells usually express cytokeratin and that some of the neoplastic cells can simultaneously express both cytokeratin and GFAP.

Choroid plexus tumors in children: immunohistochemical and scanning-electron-microscopic features.

The 30 choroid plexus tumors recorded in a large pediatric tumor registry were reviewed. The 22 choroid plexus papillomas and 8 choroid plexus carcinomas represented 2.1% of all brain tumors in the registry. The patients (19 boys, 11 girls) were aged 3 months to 12 years (mean: 2 years 9 months). All tumors and four samples of normal choroid plexus were examined with conventional histology, 9 tumors were examined with electron microscopy and 24 using immunohistochemical techniques with antisera against glial fibrillary acidic protein, S-100 protein, epidermal cytokeratin, internal organ cytokeratin and carcinoembryonic antigen. Seven of the tumors (1 carcinoma and 6 papillomas) had some positive cells with antiserum against glial fibrillary acidic protein. Twenty-seven of the tumors (90%) and all normal choroid plexus samples were positive with antiserum to S-100 protein. Some tumor cells from both types of tumor and the normal choroid plexus reacted positively with internal organ cytokeratin antiserum, but all tissue samples were nonreactive with epidermal cytokeratin antiserum. Ultrastructurally, both papillomas and carcinomas displayed cytoplasmic intermediate filaments. Transmission and/or scanning electron microscopy revealed cilia in all choroid plexus papillomas. Frequently, the cilia had an abnormal arrangement, varying from 5 + 0 to 8 + 1. This study demonstrates that tumor cells of choroid plexus origin are characterized by the presence of S-100 protein and internal organ cytokeratin antiserum. Cilia, either normal or abnormal, are consistently identified in papillomas but rarely and with difficulty in carcinomas. Carcinoembryonic antigen is seen in choroid plexus carcinomas but not papillomas.

Cytochemical identification of cerebral glycogen and glucose-6-phosphatase activity under normal and experimental conditions. II. Choroid plexus and ependymal epithelia, endothelia and pericytes.

Intracellular glycogen and glucose-6-phosphatase (G6Pase) activity were identified cytochemically within epithelia of the choroid plexus and ependyma of the cerebral ventricles including the median eminence and area postrema, the cerebral endothelium and pericytes from control, salt-stressed and fasted adult mice. Identification of glycogen was obtained by employing osmium tetroxide-potassium ferrocyanide and the periodic acid-thiocarbohydrazide-silver protein technique as ultrastructural contrast stains. A lead-capture method was used to localize G6Pase activity with glucose-6-phosphate or mannose-6-phosphate as substrate. Cerebral G6Pase functions predominantly as a phosphohydrolase to convert glucose-6-phosphate to glucose. Some glucose-6-phosphate in vivo may be derived from the breakdown of glycogen stores. Within the sampled cell types, presumptive glycogen appeared as electron-dense, isodiametric particles scattered throughout the cytoplasm. Reaction product for G6Pase activity was localized consistently within the lumen of the nuclear envelope and endoplasmic reticulum and frequently within an outer saccule of the Golgi complex under normal conditions. Choroid plexus epithelia from stressed mice exhibited a qualitative increase in cytoplasmic glycogen and a decrease in G6Pase activity; the other cell types did not express demonstrable alterations in glycogen concentration and G6Pase activity. The results indicate that glycogen and G6Pase activity are prevalent within non-neural cells of the adult mammalian CNS. Glucose utilization in the choroid plexus epithelium may be altered by stressful conditions that influence the functional activity of this cell.

Intermediate filament proteins in choroid plexus and ependyma and their tumors.

The intermediate filament protein types of normal choroid plexus and ependymal tissue and their putative tumors were investigated. In normal human choroid plexus tissue, but not in ependyma, keratin could be demonstrated immunohistochemically. By immunoblotting, keratins 8, 18, and 19 were found, but glial fibrillary acidic protein (GFAP) was absent. In mouse and rat, choroid plexus epithelium and ependymal lining cells were keratin-positive. In addition, many ependymal cells were vimentin-positive. Keratin was immunohistochemically found in three of four choroid plexus papillomas, two of two choroid plexus carcinomas, and the lining cells of three neuroepithelial cysts. GFAP-positive cells were present in some choroid plexus tumors. In contrast, none of the eight ependymomas contained keratin, but all were strongly positive for GFAP. The results show that choroid plexus lining cells and choroid plexus tumors have true epithelial characteristics in their cytoskeleton, in contrast to ependymomas, which do not show keratin positivity but show glial filaments, as would be seen in astrocytic tumors.

Neuronal accumulation of silver in brains of progeny from argyric rats.

Using a photochemical method silver was demonstrated in the brains of 1-, 14-, and 45-day-old rats which had been exposed to silver on gestational days 18 and 19. In the brain tissue of new-born rats, silver was found in the lysosomes of neurons and astroglia. Minor changes in the anatomic distribution of silver were observed between days 1 and 45. The pattern seen at day 45 was identical to that observed in silver-exposed adults. At day 1, the choroid plexus and meninges were heavily loaded with silver both intra- and extracellularly. In particular, macrophage-like cells of the meningeal spaces contained large amounts of silver. In these structures, the silver had virtually disappeared by day 45. Silver was always seen in basement membranes of the cerebral vessels.

Localization of immunoreactive prolactin in ependyma and circumventricular organs of rat brain.

Immunoreactive prolactin (IMP) has been localized in the male rat brain using the soluble peroxidase-anti-peroxidase (PAP) technique. In normal untreated animals, reaction product was seen in choroid plexus (CP) and in ependymal cells of the ventricular lining with heaviest concentrations of positively staining cells in the 3rd ventricle near the subcommissural organ (SCO), in the lateral ventricles near the subfornical organ (SFO), and in the 4th ventricle near the area postrema (AP). IMP was also present in numerous ependymal cells resembling tanycytes in the cerebral aqueduct, central canal of the spinal cord at the level of the AP, the organum vasculosum of the lamina terminalis (OVLT) and the floor of the infundibular recess. Immunoreactive cells resembling neurons were localized within the substance of the AP, SCO, and OVLT. IMP was also present in fibers of the zona externa of the median eminence and infundibular stalk; a few cells of the pars tuberalis contained reaction product. Hypophysectomized rats and bromocriptine-treated rats exhibited a similar staining pattern except that bromocriptine treatment eliminated IMP from most CP cells. Hypophysectomy, bromocriptine or estrogen treatment enhanced staining for IMP in cells of the pars tuberalis; estrogen treatment or hypophysectomy produced an increase in the number and distribution of immunoreactive cells as well as increased density of reaction product in cells of the medial habenular nucleus. The functional relevance of prolactin in these locations in the brain, the possible routes of transport of prolactin from the pituitary gland to the central nervous system, and the strong suggestion of extra-pituitary sites of synthesis of a prolactin-like hormone are discussed.

Localization of galactocerebroside in oligodendrocytes, myelin sheath and choroid plexus.

The location of galactocerebroside in brain was investigated by using a specific anti-galactocerebroside antibody which was purified by affinity chromatography. It was found that galactocerebroside is distributed not only in oligodendrocytes and myelin but also in epithelial cells of the ependymal layer of the ventricle and choroid plexus. Biochemical analysis also revealed the presence of galactocerebroside and its sulfated derivative, sulfatide, in the choroid plexus.

Lectin binding sites in the choroid plexus and choroid plexus papillomas.

The surface of the cells of the normal choroid plexus and of the plexus papillomas is coated by sialomucopolysaccharides, containing substances which are positively stained with the colloidal iron (Hale-) reaction. After pretreatment with neuraminidase sialic acid is removed rendering the membrane negative to the Hale reaction. Using FITC- or rhodamine-labelled PNA (Arachis hypogaea) and RCA (Rhicinus communis) lectins specific receptors are demonstrable. The identity of these distinct oligosaccharides containing receptors with the Thomsen-Friedenreich antigens suggests the possibility of an immunologic significance, e. g. in bacterial or viral infections of the brain. The application of histochemical techniques seem suitable to clarify the differential-diagnosis between choroid plexus papillomas on the one hand and metastasis of carcinoma and papillary ependymomas on the other hand.

A morphological and chemical study of calcification of the choroid plexus.

Human choroid plexus was submitted to low temperature ashing (LTA) in order to isolate the calcification. The ashing residue was then subjected to morphological, chemical and structural studies using technics such as scanning electron microscopy, flame and flameless atomic absorption spectrometry, infrared spectrometry and X-ray diffraction. Morphologically, the calcification consisted of wound-up fibers forming granules with a diameter of 0.05 to 0.15 mm. The concretions were identified as cristalline Ca3(PO4)2 and hydroxylapatite. The content of trace elements was high, but within the limits found in other biological apatites. In some cases, however, the Fe content exceeded these limit values.

Tissue iso-renins.

1. Several extrarenal tissues contain enzymes which are similar to kidney renin: they hydrolyse angiotensinogen to form angiotensin I; they have characteristic substrate specificity; the physicochemical properties of kidney renin and of extrarenal tissue iso-renin are similar. 2. Results indicate that tissue iso-renins are part of a complex enzyme system with mainly local function. A possible biological role has been demonstrated in brain, adrenal gland and tissue culture.

Two morphologically distinct blood-brain barriers preventing entry of cytochrome c into cerebrospinal fluid.

After intravenous injection, cytochrome c does not enter the cerebrospinal fluid. In most areas of the brain, the marker is prevented from leaving cerebral vessels by the capillary endothelium. In the choroid plexus, the marker passes freely out of capillaries into the extracellular space. However, it does not traverse tight junctions between epithelial cells and is rapidly incorporated into mnembrane-bound vesicles within the cell cytoplasm. Thereafter, cytochrome c is apparently removed by lysosomal degradation. These data suggest that there are at least two morphologically distinct blood-brain barriers to cytochrome c and that pinocytosis may be a mechanism for intracellular degradation rather than transcellular transport.