TY - JOUR
T1 - Medulloblastoma
T2 - An ultrastructural study - evidence for astrocytic and neuronal differentiation
AU - Camins, M. B.
AU - Cravioto, H. M.
AU - Epstein, F.
AU - Ransohoff, J.
PY - 1980
Y1 - 1980
N2 - Twenty medulloblastomas were studied comparatively through clinical and light and electron microscopic observations. Electron microscopy (EM) seemed important and, at times, essential in the structural characterization of these tumors. By light microscopic criteria alone, there were 12 'classical' undifferentiated cases, 7 cases showing astrocytic differentiation, and 1 'differentiated' but unclassifiable case. After reclassification by EM criteria, there were 7 undifferentiated cases, 10 cases with astrocytic differentiation, and 2 cases with neuronal differentiation; 1 case remained unclassified. The astrocytic tumor cells, showing formation of bundles of 8- to 10-nm glial fibrils, were considered true tumor cells and not 'reactive' cells, whereas the neuronal tumors contained cells showing axonal processes, dense core granules, and synaptic-like structures. The authors concluded that medulloblastomas are neoplasms of a neuroepithelial embryonic origin and as such they may remain undifferentiated or may differentiate in either an astrocytic or a neuronal direction. The glial route is common, whereas the neuronal route is rare. Medulloblastomas should be subclassified by EM criteria into three groups: I, undifferentiated; II, astrocytic; and III, neuronal. This subclassification will be of value in predicting the potential for short vs. long term survival of the patients. Patients with astrocytic tumors (Subgroup II) had a longer survival than those with undifferentiated tumors (Subgroup I): 4.6 vs. 3.5 years. The undifferentiated tumors were located predominantly in the midline, whereas tumors showing astrocytic differentiation were located equally in the midline or in the cerebellar hemisphere.
AB - Twenty medulloblastomas were studied comparatively through clinical and light and electron microscopic observations. Electron microscopy (EM) seemed important and, at times, essential in the structural characterization of these tumors. By light microscopic criteria alone, there were 12 'classical' undifferentiated cases, 7 cases showing astrocytic differentiation, and 1 'differentiated' but unclassifiable case. After reclassification by EM criteria, there were 7 undifferentiated cases, 10 cases with astrocytic differentiation, and 2 cases with neuronal differentiation; 1 case remained unclassified. The astrocytic tumor cells, showing formation of bundles of 8- to 10-nm glial fibrils, were considered true tumor cells and not 'reactive' cells, whereas the neuronal tumors contained cells showing axonal processes, dense core granules, and synaptic-like structures. The authors concluded that medulloblastomas are neoplasms of a neuroepithelial embryonic origin and as such they may remain undifferentiated or may differentiate in either an astrocytic or a neuronal direction. The glial route is common, whereas the neuronal route is rare. Medulloblastomas should be subclassified by EM criteria into three groups: I, undifferentiated; II, astrocytic; and III, neuronal. This subclassification will be of value in predicting the potential for short vs. long term survival of the patients. Patients with astrocytic tumors (Subgroup II) had a longer survival than those with undifferentiated tumors (Subgroup I): 4.6 vs. 3.5 years. The undifferentiated tumors were located predominantly in the midline, whereas tumors showing astrocytic differentiation were located equally in the midline or in the cerebellar hemisphere.
UR - http://www.scopus.com/inward/record.url?scp=0018837640&partnerID=8YFLogxK
U2 - 10.1227/00006123-198004000-00008
DO - 10.1227/00006123-198004000-00008
M3 - Article
C2 - 7393422
AN - SCOPUS:0018837640
SN - 0148-396X
VL - 6
SP - 398
EP - 411
JO - Neurosurgery
JF - Neurosurgery
IS - 4
ER -