Ultrastructural and electrophysiological features of meningioma whorls in tissue culture

Meningiomas

This article reviews the recent literature on the pathogenesis and pathology of meningiomas, contemporary techniques of surgical resection, and new nonsurgical treatments, including radiation and hormone therapy. Factors predisposing to meningioma formation include female sex, previous ionizing radiation, and Type 2 neurofibromatosis. The first factor may act through the expression of sex hormone receptors, especially the progesterone receptor, in these tumors; the other two probably act by causing a deletion on Chromosome 22. The pathological classifications of meningiomas include the traditional division into histological subtypes and the World Health Organization classification that selects characteristics that may lead to recurrence. There is an increasing emphasis on proliferative indices and other characteristics that may predict aggressive behavior in these tumors. On computed tomography, meningiomas are enhancing, well-marginated, dural-based lesions that may have considerable surrounding edema; the cause of the edema is uncertain but may result from secretory products of the tumor. Magnetic resonance imaging with enhancement will demonstrate these lesions accurately and can be used for three-dimensional reconstruction as well. Computed tomography and magnetic resonance imaging have largely replaced angiography in the preoperative diagnosis of meningiomas, but angiographic embolization may be a useful operative adjunct. Although meningioma surgery is sometimes thought of as benign and curative, the reported surgical mortality rate is as high as 14.3% and the reported 10-year survival rate after surgery varies from 43 to 77%. Surgery has advanced most in the management of suprasellar, cavernous sinus, clivus, tentorial, and posterior fossa meningiomas, because new approaches and a better understanding of anatomy have allowed more radical resection. There is still substantial morbidity associated with surgery in these regions, however, and the long-term recurrence rates are still unknown for these new radical techniques. For convexity, parasagittal, lateral sphenoid wing, and olfactory groove meningiomas, complete resection should be the goal and operative morbidity appears to be low. There is a high recurrence rate after surgery. With apparent total removal, the recurrence rate varies from 9 to 20% at 10 years, with subtotal resection varying from 18.4 to 50%. The degree of resection appears to be most important in recurrence, but histopathological features are also important. Recently, radiation therapy has been recognized as a useful adjunct to surgery, and with radiosurgical techniques may become more important in the future. Antiprogesterone therapy appears to have had some success as well, and it or other hormonal therapy may be another future option for residual or recurrent meningiomas.

Hormonal manipulation of meningiomas in vitro

Speculation that meningiomas are subject to endocrine influence is supported by their higher incidence in women, reports of exacerbation of symptoms during pregnancy, and the discovery that these tumors harbor progesterone- and estrogen-binding proteins. To evaluate if these properties could be exploited therapeutically, specimens from three convexity meningiomas were used for estrogen- and progesterone-binding protein assays and establishment of tissue cultures. Each tumor (designated A, B, and C, respectively) was grown in experimental media containing 7.5 X 10(-5) to 10(-12) M 17 beta-estradiol, 2.5 X 10(-4) to 10(-12) M progesterone, 10(-7) to 10(-9) M tamoxifen (an estrogen antagonist), and 10(-6) to 10(-10) M RU486 (a progesterone antagonist). After incubation, cell growth was compared to control preparations by counting the meningioma cells present in each medium. Tumors A, B, and C contained estrogen-binding proteins of 8.45, 13.6, and 26.9 fmol/mg cytosol protein and progesterone-binding proteins of 210, 130, and 126 fmol/mg cytosol protein, respectively. The media containing 17 beta-estradiol and progesterone caused 21% to 36% growth stimulation in Tumors A and B. In Tumor A, the addition of tamoxifen stimulated growth by 35%, while it caused only transient stimulation in Tumor B and had no effect on Tumor C. RU486, the progesterone antagonist, caused inhibition of cell growth in all three tumors, ranging from 18% to 36%. These data suggest that selected meningiomas are subject to hormonal influence in vitro. The inhibition of meningioma growth in vitro by the antiprogesterone, RU486, has not been previously reported, and serves to encourage further development of alternative modes of therapy for recurrent and unresectable meningiomas.

Immunological, biochemical, ultrastructural, and electrophysiological characteristics of a human glioblastoma-derived cell culture line

This report presents the results of a study using multiple techniques of the established human cell line, LM, which has been developed in culture medium from a patient with a right temporoparietal glioblastoma. This cell line has human subtetraploid karyotype and has several features of a transformed line in culture. These include continuous propagation for 10 years, ability to form tumor nodules when transplanted into immunologically suppressed hamsters, and pleomorphic appearance. Ultrastructurally, it is characterized by multiple nuclei, few actin cables, and numerous surface-membrane microvilli, as well as abundant 9- to 10-nm cytoplasmic filaments. By its immunological reactivity, the line can be shown to contain glial fibrillary acidic protein at low levels, consistent with its glial origin and continued nature. Dibutyryl cyclic adenosine monophosphate (db-cAMP) induces formation of long astrocytic-like processes as well. Its membrane electrical characteristics include a low resting membrane potential and short time constant. Used in a microtiter antiglioma antibody cytotoxicity assay, LM yields a positive reaction to antibodies in the sera of 80% of patients with astrocytomas and only 9% of normal blood-bank donors, suggesting that it shares common antigens with other astrocytic tumor lines. The varied characteristics of this glioblastoma-derived line emphasize the "multiforme" nature on the neoplasm and suggest that for characterization of any such line, multiple parameters are necessary to allow comparison with other long-term glioblastoma lines in the literature. The usefulness of the LM line in in vitro cell biological, immunological, chemotherapeutic, and radiobiological studies of gliomas makes such efforts very worthwhile.

Immunohistochemical demonstration of IgG in meningioma

Twenty human meningiomas were examined for IgG and IgM by the direct immunofluorescence of immunoperoxidase methods, or both. IgG was conspicuously found in and around the blood vessels, whorls, and psammoma bodies. It was also clearly present on the cytoplasmic membranes of the tumour cells. On the other hand, IgM was seen only within the blood vessels. Significance of these findings is briefly discussed including possible humoral immune reactions in regard to whorl and psammoma body formation in meningioma.