title: Progressive enlargement of a mass lesion in late cerebral radionecrosis.
abstract: The progressive enlargement of a mass lesion in late cerebral radionecrosis (LCR) was studied using a surgical specimen from a woman's irradiated brain. Using immunohistochemical (IHC) staining on paraffin-embedded sections, expression of tumor necrosis factor-alpha (TNFα), interleukin (IL)6, Flk-1, and vascular endothelial growth factor (VEGF) was semi-quantitatively evaluated in the necrotic area and areas distant and adjacent to the necrotic area. High immunoreactivity for TNFα, IL6, and VEGF in regions distant to the necrotic core were strongly associated with inflammatory cell density, hyalinized vessels, and vascularization. Ghost cells stained with glial fibrillary acidic protein (GFAP), Ki-M1P, KP-1, ubiquitin-C-terminal hydrolase 1, and fibrinoid necrosis were observed in the necrotic area and adjacent regions. These results suggest that necrotic factors, inflammatory reaction, and angiogenetic factors act temporally and spatially through radiation-induced vascular endothelial cell damage to contribute to the progressive enlargement of an enhancing mass lesion in LCR.
authors.affiliation: Tsukuba Memorial Hospital, Tsukuba Brain and Spine Center, Tsukuba-city, Ibaraki, Japan. yoshii_y@tsukuba-kinen.or.jp
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yoshii
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Kyoko
authors.initials: K
authors.lastname: Fujiwara
mesh_terms: D002540:Cerebral Cortex / Q000473:pathology* / Q000528:radiation effects*; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D018317:Nerve Sheath Neoplasms / Q000532:radiotherapy; D009419:Nerve Tissue Proteins / Q000378:metabolism; D011878:Radiotherapy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism
chemical_list: D016207:Cytokines; D009419:Nerve Tissue Proteins; D042461:Vascular Endothelial Growth Factor A; D040301:Vascular Endothelial Growth Factor Receptor-2