Morphological and ultrastructural findings of prognostic impact in craniopharyngiomas.
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.
Agozzino
Lucio
L
Department of Public Health, Section of Pathology, Second University of Naples, Naples, Italy. lucio.agozzino@unina2.it
Ferraraccio
Franca
F
Accardo
Marina
M
Esposito
Salvatore
S
Agozzino
Manuela
M
Cuccurullo
Luigi
L
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
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A