A clinicopathological study of malignant glioma done after local administration of chemotherapeutic agents.
Light and electron microscopic studies on tumor tissue from 5 autopsied and 7 rebiopsied patients with malignant glioma after receiving intratumor administration of anti-neoplastic agents were made. Four patients were correlated with their serial MRI. After craniotomy 0.5 mg of adriamycin was administered using an Ommaya reservoir into the tumor bed. Light microscopy of the recurrent tumor and adjacent necrotic tissue revealed massive coagulation necrosis which was aspirated into the tip of the Ommaya tube. Around the massive coagulation necrosis and cystic cavity, abundant reactive collagenous tissues, gliomesenchymal tissue, infiltrating lymphocytes, and a small amount of foreign body giant cells were found concomitantly with organized necrotic tissue. The electron microscopic study of the above mentioned tissue showed deposits of lipofuscin, lipid droplets, lysosomes in the tissue as well as abundant disintegrated myelin figures and fibrous strands. Furthermore, marked histological necrosis was found mainly at the tip of the Ommaya tube. These morphological findings corresponded to the high signal intensity areas on the gadolinium-enhanced T1-weighted MRI. These facts may indicate that the antineoplastic agents administered directly to a tumor per se cause morphological alternations. Moreover, these facts may suggest a therapeutic effect in the residual tumor cells which would be facilitated by formation of coagulation necrosis and collagenous tissue.
Shimura
T
T
Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.
Teramoto
A
A
Nakazawa
S
S
Aihara
K
K
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
D000970:Antineoplastic Agents