RESUMEN
For the past 140 years, intracerebral hemorrhages (ICHs) and miliary aneurysms have been in widespread controversy focusing on autopsied brains. Between 2004 and 2005, the author performed pathological and three dimensional reconstructive studies in surgical specimens that neurosurgeons had confirmed as bleeding points during microsurgery to be the cause of an intracerebral hemorrhage. All of small arteries collected from 42 patients revealed acute arterial dissections at 126 points. And a not ruptured miliary aneurysm was found, of which wall consisted of collagen fibrils. The possibility of rupture in the future was deemed high, with the risk of an ICH. In addition, an acute arterial dissection with the circumference of whole the muscular layer was found and showed thickened collagen fibrils in the adventitia. This type of dissection was thought to have possibility of the cause of the miliary aneurysm.
Asunto(s)
Disección Aórtica/patología , Arteriolas/patología , Arterias Cerebrales/patología , Hemorragia Cerebral/patología , Aneurisma Intracraneal/patología , Disección Aórtica/etiología , Autopsia , Hemorragia Cerebral/etiología , Humanos , Aneurisma Intracraneal/etiología , Manejo de EspecímenesRESUMEN
Three-dimensional reconstructive analyses revealed that the intracytoplasmic lumina found in ependymomas were actually formed by subsidence of an extracellular membrane, resembling a volcano. This finding was compatible with cytologic and electron microscopic findings. In addition, there were many tiny thorns resembling a holly leaf on the extracellular membrane, such that cilia and microvilli on the cellular membrane discontinued cell-to-cell tight junctions.
Asunto(s)
Neoplasias del Ventrículo Cerebral/diagnóstico , Citoplasma/diagnóstico por imagen , Citoplasma/patología , Ependimoma/diagnóstico , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Neoplasias de la Médula Espinal/diagnóstico , Adulto , Neoplasias del Ventrículo Cerebral/patología , Neoplasias del Ventrículo Cerebral/cirugía , Neoplasias del Ventrículo Cerebral/ultraestructura , Citoplasma/ultraestructura , Ependimoma/patología , Ependimoma/cirugía , Ependimoma/ultraestructura , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Microscopía Electrónica , Neoplasias de la Médula Espinal/patología , Neoplasias de la Médula Espinal/cirugía , Neoplasias de la Médula Espinal/ultraestructura , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Oligodendrogliomas, which have a relatively better prognosis than tumors of the astrocytic lineage, have few morphologic clues for diagnosis. CASE: To address this problem, eosinophilic refractile inclusions were examined cytologically in the tumor of a 59-year-old man, using surgical materials for rapid diagnosis. Cytologic, histologic, and immunohistochemical findings were compatible with the refractile eosinophilic inclusions found in oligodendroglial tumors. The tumor cells presented a sheet-like epithelial pattern, forming no overlapping cell clusters, with an ill-defined cytoplasmic membrane, and nuclei that appeared to be naked, approximately 2 times the size of a red blood cell (approximately 7 microm) in diameter. It was easier to examine the cells and inclusions by cytologic preparations than by histology. CONCLUSION: The inclusions were thought to be a diagnostic clue for oligodendrogliomas, especially on cytology, and cytology was more useful than histology.