Primary cerebral blastomatous reticulosis. Clinical, pathohistological and ultrastructural study

Primary non-Hodgkin's lymphomas of the CNS

This paper reports on 10 patients (4 male, 6 female) with primary non-Hodgkin's lymphomas of the brain (CNS-NHL--mean age 46.8 years, mean postdiagnostic survival 10 months). Pathological CSF (cerebrospinal fluid) was found in all 8 patients examined (positive cytology in 7/8 cases). Solitary tumors, diffuse periventricular infiltration or diffuse cerebral infiltration were demonstrated in cerebral computer-assisted tomography (CAT). Angiographical findings were unspecific. The histologic subtypes were lymphoplasmacytoid immunocytoma (4), unclassified low grade (1), centroblastic (1), B-immunoblastic (1), T-immunoblastic (1), lymphoblastic convoluted T-cell type (1), unclassified high grade (1) NHL. Patients who had received radiotherapy (+/- surgery) in this group had a mean survival of 15.66 months (sigma = 7.63). In addition, an overview of 83 well-documented, cases of the literature tries to characterize main histological and topographical distributions, histology-, patient's age-, and therapy-related survival. Patients with primary CNS-NHL have a 5-year survival expectancy of 30% compared with 2.3% in secondary CNS-manifestations of systemic non-Hodgkin's lymphomas. In this report, the beneficial effect of radiotherapy (mean survival 30.3 months) compared to surgery or symptomatic treatment (3.6 or 3.3 months) could be confirmed. It is concluded that primary CNS-NHL frequently present with atypical neuropsychiatric syndromes; diagnosis should be established preferentially with CAT and CSF-examinations or stereotactic biopsies, whereas open surgery should be avoided. An approach to exact classification should be attempted, as survival is clearly related to histological subtypes.

Human and experimental reticulum cell sarcoma (microglioma) of the nervous system

The histology and ultrastructure of primary central nervous system and metastatic (epidural) reticulum cell sarcoma is described. The tumors showed varying numbers of argyrophilic microglial cells which in all cases constituted a minority of all tumor cells. A primitive, undifferentiated cell, common to all tumors, was a small cell with a large dense nucleus and a narrow rim of poorly structured cytoplasm. These cells frequently showed small fatty inclusions and were tentatively identified as primitive multipotential cells from which all other tumor cells develop. It is concluded that reticulum cell sarcoma of the nervous system (primary or metastatic) and microglioma or microgliomatosis are one and the same tumor.

Primary cerebral reticulosis and plasma cell diffenentiation

Cerebral proliferative and tumour forming reticulosis are primary pathologic processes of the brain originating in the perivascular adventitial cell. In these conditions this cell can transform into a histiocyte or microglial cell with characters of a macrophage. A reactive cell with endoplasmic reticulum, basement membrane and fibril forming properties, is also present (fibril forming reticular cell). The malignant tumours of the perivascular spaces (cerebral reticulosarcoma) are characterized by the presence of the dedifferentiated cells originating from the intraadventitial cell. Under both proliferative and tumour forming conditions this cell may transform into a cell rich in endoplasmic reticulum, sometimes charged with Russell bodies and corresponds morphologically to the protein-forming plasma cell. The properties of the intracerebral periadventitial cells are identical with those of the reticulo-histiocytic system described by ASCHOFF. As its structure and the elements into which it differentiats sharply differ from those of the cells belonging to the lymphocyte series the term malignant lymphoma of the brain given to these processes does not correspond to the fundamental characters of these pathological process.