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2 results

  • Eosinophil Infiltrates in Pilocytic Astrocytomas of Children and Young Adults

  • Jian-Qiang Lu, Omid Rashidipour, Beverly A. Wilson, Andrew S. Jack, Jeffrey Pugh, Vivek Mehta
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 41 / Issue 5 / September 2014
    Published online by Cambridge University Press:
    30 October 2014, pp. 632-637
    • Article
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  • Objective

    Eosinophils may affect each stage of tumour development. Many studies have suggested that tumour-associated tissue eosinophilia (TATE) is associated with favourable prognosis in some malignant tumours. However, only a few studies exist on TATE in central nervous system (CNS) tumours. Our recent study exhibited eosinophils in atypical teratoid/rhabdoid tumours (AT/RTs), pediatric malignant CNS tumours with divergent differentiation. This study examines eosinophils in pilocytic astrocytomas (PAs).

    Methods

    The study included 44 consecutive cases of patients with PAs and no concurrent CNS inflammatory disease.

    Results

    We found eosinophils in 19 (43%) of 44 PAs (patient age range, 0.5-72 years). Eosinophils were intratumoural and clearly distinguishable. The density of eosinophils was rare to focally scattered. PAs containing eosinophils were located throughout the CNS. Furthermore, eosinophilic infiltration was identified in 18 (62%) of 29 pediatric (age range, 0.5-18 years) PAs but only 1 (7%) of 15 (p<0.001, significantly less) adult (age range, 20-72 years) PAs. Eosinophilic infiltration showed no significant differences between PAs with and without MRI cystic formation, surgical procedures, or PAs with and without leptomeningeal infiltration. In comparison, eosinophils were absent in 10 pediatric (age range, 0.5-15 years) ependymomas (or anaplastic ependymomas).

    Conclusions

    These results suggest that eosinophils are common in pediatric PAs but rare in adult PAs. This difference is probably related to the developing immune system and different tumour-specific antigens in children. TATE may play a functional role in the development of pediatric PAs, as well as some other pediatric CNS tumours such as AT/RTs.

  • Chapter 40 - Fragile X syndrome

  • from Section 3 - Symptomatic epilepsy
  • Edited by Simon D. Shorvon, Frederick Andermann, Renzo Guerrini
  • Book:
    The Causes of Epilepsy
    Published online:
    05 March 2012
    Print publication:
    14 April 2011, pp 272-276

  • Summary

    Neurofibromatosis 1 (NF1) and neurofibromatosis 2 (NF2) are inherited tumor predisposition syndromes that have a major impact on the nervous system but are clinically and genetically distinct disorders. This chapter discusses the clinical characteristics and genetics of the neurofibromatoses and presents the current knowledge about their relationship with epilepsy. As neurofibromin acts as a tumor suppressor, NF1 individuals are at increased risk of developing benign and malignant tumors, particularly pilocytic astrocytomas, although pilomyxoid astrocytomas and glioblastoma multiforme can occur. The treatment of NF1 is based on assiduous monitoring for disease complications and treatment of the specific disease manifestations. NF2 should be distinguished from schwannomatosis, a rare condition characterized by the development of painful schwannomas involving the cutaneous, peripheral, and spinal nerves. The diagnosis of NF2 is made according a combination of skin, eye, and central and peripheral nervous system manifestations.