title: Morphological and ultrastructural findings of prognostic impact in craniopharyngiomas.
abstract: Craniopharyngioma is a slow-growing epithelial tumor with an unpredictable tendency to recur. To verify the reliability in predicting the clinical outcome, some morphological and immunohistochemical findings were analyzed in 37 primitive tumors and in 6 recurrences (one recurred twice). All the tumors were surgically excised and all recurrences exhibited an adamantinomatous pattern; mitotic rate was low (< 5 x 10 HPF) in both recurrent and in nonrecurrent tumors. Primary tumors showed a mean positivity of 1.7% (range 0.3-2%) to PCNA vs. 4.1% (range 0.3-8%) in recurrences. The MIB-1 Labelling Index was: 22.12% in primary tumors, 27.5% in recurrences, 31.3% in adult nonrecurrent tumors, and 4.1% in the pediatric tumor. CD34 labeling vessels/field was 9.3 in primary tumors and 9.91 in the recurrences; VEGF expression was higher in recurrences than in primary tumors (40 vs. 25%). Ultrastructural analysis showed fenestrated endothelium with hydropic changes in VEGF-positive vessels. Lack of clear correlations between morphological or immuno-staining patterns and behavior suggests that these features have no prognostic value in adult as well as in pediatric craniopharyngiomas. In this study, the only results that may be related to the aggressiveness of tumor is the major vascularization in the recurrent tumors in which the vessels show also ultrastructural changes.
authors.affiliation: Department of Public Health, Section of Pathology, Second University of Naples, Naples, Italy. lucio.agozzino@unina2.it
authors.forename: Lucio
authors.initials: L
authors.lastname: Agozzino
authors.forename: Franca
authors.initials: F
authors.lastname: Ferraraccio
authors.forename: Marina
authors.initials: M
authors.lastname: Accardo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Esposito
authors.forename: Manuela
authors.initials: M
authors.lastname: Agozzino
authors.forename: Luigi
authors.initials: L
authors.lastname: Cuccurullo
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D003593:Cytoplasm / Q000648:ultrastructure; D004730:Endothelium, Vascular / Q000648:ultrastructure; D004847:Epithelial Cells / Q000648:ultrastructure; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A