Comprehensive lectin histochemistry of normal and neoplastic human choroid plexus cells: alternation of lectin-binding patterns through neoplastic transformation

Tumors of the choroid plexus

Choroid plexus tumors are rare intraventricular papillary neoplasms derived from choroid plexus epithelium, which account for only between 0.4-0.6% of all intracranial and 2-3% of pediatric neoplasms. Plexus papillomas outnumber choroid plexus carcinomas by a ratio of 5:1 and around 80% of choroid plexus carcinomas arise in children. Plexus tumors are most common in the lateral and fourth ventricles; while 80% of lateral ventricle tumors present in children, fourth ventricle tumors are evenly distributed in all age groups. Clinically, choroid plexus tumors tend to cause hydrocephalus and increased intracranial pressure. Histologically, choroid plexus papillomas correspond to WHO grade I, choroid plexus carcinomas to WHO grade III. Immunohistochemically, cytokeratins and vimentin are expressed by virtually all choroid plexus papillomas and most choroid plexus carcinomas while transthyretin and S-100 protein are present in 80-90% of cases, less frequently, though, in choroid plexus carcinomas. Glial fibrillary acidic protein can be found focally in about 25-55% of choroid plexus papillomas and 20% of choroid plexus carcinomas. The mean Ki67/MIB1 labeling index for choroid plexus papillomas is 1.9%, for choroid plexus carcinomas 13. 8%. Choroid plexus papillomas typically show hyperdiploidy with gains particularly on chromosomes 7, 9, 12, 15, 17, and 18 while one choroid plexus carcinoma showed rearrangements of chromosomes 7p11-12, 9q11-12, 15q22, and 19q13.4. Choroid plexus papillomas can usually be cured by surgery alone with a 5-year survival rate of up to 100% with occasional recurrences while choroid plexus carcinomas grow more rapidly and have a less favorable outcome with a 5-year survival rate of 26-40%.

Pathology of choroid plexus papillomas: a review

Choroid plexus papillomas (CPPs) are rare, usually slow growing neoplasms. Their biological behaviour cannot be predicted in an individual case. Furthermore, the neuropathological diagnosis of these neoplasms is occasionally difficult because light and electron microscopical and immunohistochemical features may overlap with those of other neoplasms localising in the choroid plexus. The aim of this paper is to review the pathological literature (light and electron microscopy (EM) and immunocytochemistry), to provide guidance on current diagnostic tools and criteria and address the identification of 'atypical' CPPs, e.g. those CPPs with histological features indicative of aggressive behaviour, in an attempt to help bridge the diagnostic gap between benign CPPs on the one hand and choroid plexus carcinomas (CPCs) on the other.

A systematic histochemical investigation in mammals of the dense glycocalyx glycosylations common to all cells bordering the interstitial fluid compartment of the brain

Microanatomical evidence is presented that the intercellular fluid (ICF) compartment of the central nervous tissue is lined entirely and exclusively by heavily glycosylated cells, with glycoconjugates exposed primarily at the apical cell surface, fronting the CSF or blood. On both common ependymal cells and on those specialised to form the choroid plexus epithelium, oligosaccharides coat the cilia and microvilli at the apical surface, and also the smoother lateral and basal cell surfaces. In the ependyma, folded and wrinkled structures seem especially associated with freely exposed carbohydrates. On cerebral endothelial cells, oligosaccharides coat the luminal surface densely and the basal surface lightly. The patterns of carbohydrate distribution thus vary from one cell type to another, but the different cell types all bear essentially the same set of oligosaccharides, variations being due largely to degree of terminal sialylation. Furthermore, the same set of oligosaccharides borders the brain in a broad spectrum of mammals, including pouched and placental mammals. In both epithelia and endothelia, the lectin binding sites visualised in fixed and embedded preparations were shown to be exposed likewise at the cell surfaces in unfixed tissues and so able to bind molecules present in the fluid (CSF or blood) bathing the cells in vivo. This phylogenetically ancient enclosure of the ICF compartment in a "ring of sugars" is suggested to relate to regulation of the central neuronal microenvironment.

The ependyma: a protective barrier between brain and cerebrospinal fluid

This review summarizes the current scientific literature concerning the ependymal lining of the cerebral ventricles of the brain with an emphasis on selective barrier function and protective roles for the common ependymal cell. Topics covered include the development, morphology, protein and enzyme expression including reactive changes, and pathology. Some cells lining the neural tube are committed at an early stage to becoming ependymal cells. They serve a secretory function and perhaps act as a cellular/axonal guidance system, particularly during fetal development. In the mature mammalian brain ependymal cells possess the structural and enzymatic characteristics necessary for scavenging and detoxifying a wide variety of substances in the CSF, thus forming a metabolic barrier at the brain-CSF interface.

Lectin histochemistry of normal and neoplastic peripheral nerve sheath. 2. Lectin binding patterns of schwannoma and neurofibroma

Lectin binding patterns of 31 schwannomas and 6 neurofibromas were examined using 12 lectins, and the results were compared with those of normal peripheral nerves. Tumors obtained from 10 cases of neurofibromatosis and 4 recurrent schwannomas were included. Changes of glycoconjugates were observed in association with a neoplastic transformation of Schwann cells; Arachis hypogaea (PNA) staining after neuraminidase treatment seen in normal Schwann cells was reduced in schwannoma of Antoni type A, and bindings with Glycine max (SBA) and Helix pomatia (HPA) after sialic acid removal, which were not seen in normal Schwann cells, appeared in schwannoma cells. Intensities of staining of tumor cells with each lectin were higher in Antoni type B than those in Antoni type A. No differences in lectin binding patterns were observed between schwannomas in patients with neurofibromatosis or recurrent schwannomas and ordinary, primary schwannomas in patients without stigmata of neurofibromatosis. Lectin binding patterns of Schwann cells and perineurial cells in neurofibroma were almost similar to those in normal peripheral nerves with an exception of faint stain of Schwann cells with HPA after neuraminidase pretreatment. This result suggests differences in extent of differentiation between schwannoma cells and neoplastic Schwann cells in neurofibroma. Specific PNA binding to perineurial cells in neurofibroma indicates the significance of this lectin as a marker of these cells.

Colloid cyst of the third ventricle. A comparative immunohistochemical study of neuraxis cysts and choroid plexus epithelium

In an effort to shed light upon the nature of the colloid cyst, the immunohistochemical properties of 21 examples of this lesion were compared with those of other neuraxial cysts and choroid plexus epithelium. The neuraxial cysts included the following: eight Rathke's cleft cysts, 25 pituitaries containing follicular cysts of the pars intermedia, and four enterogenous cysts. Fifteen examples of normal choroid plexus and 12 choroid plexus papillomas were studied as well. These lesions were examined for localization of the following antigens: cytokeratins, epithelial membrane antigen, secretory component, carcinoembryonic antigen, prealbumin, vimentin, glial fibrillary acidic protein (GFAP), S-100 protein, neuron-specific enolase, 68-kD neurofilament protein, chromogranin, serotonin, and lysozyme, and with Leu-7 monoclonal antibodies. Five colloid cysts were immunostained with monoclonal antibodies that were specific for Clara-cell antigens and surfactant, respectively. Sugar moieties were localized using Ulex europaeus I, and Ricinus communis agglutinin I lectins. All Rathke's cleft cysts and follicular cysts of the pars intermedia as well as three selected colloid cysts were examined for pituitary hormones. The epithelial cells of colloid and enterogenous cysts, as well as those lining follicular and Rathke's cleft cyst, showed uniformly strong reactivity for cytokeratins, epithelial membrane antigen, secretory component, and vimentin, and bound Ulex europaeus lectin. Occasional cells in colloid cysts were positive for Clara cell-specific antigens. Reaction for carcinoembryonic antigen was present on the apical surface of scattered cells of colloid, follicular, and Rathke's cleft cysts. Many cells of follicles in the pars intermedia as well as individual cells of five Rathke's cleft cysts were also immunoreactive for chromogranin, S-100 protein, GFAP, and pituitary hormones. Colloid and enterogenous cysts were negative for prealbumin, S-100 protein, GFAP, and neuron-specific enolase; in all but a few instances, they failed to bind Ricinus communis agglutinin. In contrast, normal choroid plexus and choroid plexus papillomas were positive for prealbumin, S-100 protein, neuron-specific enolase, cytokeratin, vimentin, and Ricinus communis agglutinin receptors; they lacked Ulex europaeus lectin, 56/66-kD cytokeratins, and epithelial membrane antigen. Unlike normal choroid plexus, choroid plexus papillomas were often GFAP-positive. All tissues studied were nonreactive for lysosome, serotonin, and neurofilament, and with Leu-7 antibodies. This study indicates that the immunophenotype of epithelium lining colloid cysts is similar to that of other cysts showing endodermal or ectodermal differentiation and to respiratory tract mucosa. Epithelium of colloid cysts is immunohistochemically different from that of normal or neoplastic choroid plexus. These findings indicate an endodermal rather than neuroepithelial nature for colloid cysts.

Distribution of cellular carbohydrate moieties in human dysontogenetic brain tumors, especially in craniopharyngioma and epidermoid/dermoid

Cellular carbohydrate moieties of 65 human dysonotogenetic brain tumors (craniopharyngioma, epidermoid/dermoid, Rathke cleft cyst, germinoma and non-germinomatous germ-cell tumors) and 60 common brain tumors (glioma, meningioma, neurinoma and pituitary adenoma) were investigated histochemically using sections from Ulex europaeus (UEA-1), Dolichos biflorus (DBA), peanut (PNA) and soybean (SBA), and with anti-blood group A and LewisY (LeyY) antibodies. In craniopharyngiomas and epidermoid/dermoids, it was found that PNA and SBA binding sites existed in suprabasal cells of the epithelium, and that antigen of either blood group A or H (demonstrable by UEA-1) existed in more differentiated epithelial cells compared to the results reported in normal human skin epidermis. Rathke cleft cysts were stained with PNA or SBA, and two out of three Rathke cleft cysts also expressed either H or A antigen. In addition, DBA binding sites, as well as LeY antigen, were frequently seen in craniopharyngiomas and Rathke cleft cysts, but they were entirely absent in the epithelium of epidermoid/dermoid. On the other hand, PNA and SBA reactivities was also found in common brain tumors, while blood group A, H and LeY antigens and DBA reactivity were almost absent in these tumors. These findings demonstrate that carbohydrate moieties such as those of blood group antigens reported to be found in human skin epidermis exist in a similar form in craniopharyngioma, epidermoid/dermoid and the Rathke cleft cyst. The identification of blood group A, H and LeY antigens and DBA reactivity in brain tumors seems to be considerably limited and specific.(ABSTRACT TRUNCATED AT 250 WORDS)

Dolichos biflorus agglutinin binding to intracranial germ-cell tumors: detection of embryonal components in germinomas

Dolichos biflorus agglutinin (DBA) binding was examined in 32 cases of intracranial human germ-cell tumors. In embryonal carcinomas, intense DBA binding sites were found on the free surface and cytoplasm of embryonal cells. In teratomas, glandular structures often had positive DBA binding sites. Yolk sac carcinomas and choriocarcinomas showed negative DBA affinity. Of 19 cases of germinomas, 10 showed no DBA-positive cells, while sporadically and/or collectively distributed-DBA positive cells were found in the other 9 cases. Common brain tumors such as gliomas, neurinomas and meningiomas were negative for DBA staining. Considering the cellular carbohydrate structure, these findings suggest that DBA-positive cells in germinoma might be evidence of differentiation into embryonal or some somatic components. In addition, because of the absence of DBA binding sites in the common brain tumors, the identification of such binding sites in brain tumors might act as a marker for embryonal or somatic components, especially among germ-cell tumors.