Summary
An autopsy case of anaplastic ganglioglioma in the brain stem of a 12-year-old girl is reported. The ill-defined tumor involved the right cerebellar peduncle, medulla oblongata and upper cervical spinal cord, and showed mixed proliferation of many ganglioid cells and atypical pilocytic astrocytes with necrotic areas. Immunohistochemical studies revealed the presence of chromogranin A in most ganglioid cells and of metenkephalin in some large ganglioid cells. Glial cells were positive for glial fibrillary acidic protein and vimentin. Ultrastructurally, numerous dense-core granules of 90–220 nm in diameter were demonstrated in ganglioid cells and abundant glial filaments in glial cells. High neurosecretory activity in neuronal cells, suggested by chromogranin-immunoreactivity and dense-core granules, seems to be the most characteristic property of ganglion cell tumors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allegranza A, Pileri S, Frank G, Ferracini R (1990) Cerebral ganglioglioma with anaplastic oligodendroglial component. Histopathology 17:439–441
Bevilacqua G, Sarnelli R (1979) Ganglioglioma of the spinal cord. A case with a long survival. Acta Neuropathol (Berl) 48:239–242
Bowles AP, Pantazis CG, Allen MB, Martinez J, Allsbrook WC (1988) Ganglioglioma, a malignant tumor? Correlation with flow deoxyribonucleic acid cytometric analysis. Neurosurgery 23:376–381
Burger PC, Scheithauer BW, Vogel FS (1991) Neuronal neoplasms and hamartomas. In: Surgical pathology of the nervous system and its coverings, 3rd edn. Churchill Livingstone. New York, pp 324–338
Ferrer I, Ribalta T, Digon E, Acebes J (1983) Cerebral ganglioglioma. A Golgi study. Virchows Arch [A] 400:69–75
Garcia CA, McGarry PA, Collada M (1984) Ganglioglioma of the brain stem. Case report. J Neurosurg 60:431–434
Hall WA, Yunis EJ, Albright AL (1986) Anaplastic ganglioglioma in an infant: case report and review of the literature. Neurosurgery 19:1016–1020
Hearn SA (1987) Electron microscopic localization of chromogranin A in osmium-fixed neuroendocrine cells with a protein A-gold technique. J Histochem Cytochem 35:795–801
Hoog A, Gould VE, Grimelius L, Franke WW, Falkmer S, Chejfec G (1988) Tissue fixation methods after the immunohistochemical demonstrability of synaptophysin. Ultrastruct Pathol 12:673–678
Johannsson JH, Rekate HL, Roessmann U (1981) Gangliogliomas: pathological and clinical correlation. J Neurosurg 54:58–63
Kalyan-Raman UP, Olivero WC (1987) Ganglioglioma: a correlative clinicopathological and radiological study of ten surgically treated cases with follow-up. Neurosurgery 20:428–433
Kawai K, Takahashi H, Ikuta F, Tanimura K, Honda Y, Yamazaki H (1987) The occurrence of catecholamine neurons in a parietal lobe ganglioglioma. Cancer 60:1532–1536
Kitano M, Takayama S, Nagao T, Yoshimura O (1987) Malignant ganglioglioma of the spinal cord. Acta Pathol Jpn 37:1009–1018
Li JY, Racadot O, Kujas M, Kouadri M, Peillon F, Racadot J (1989) Immunocytochemistry of four mixed pituitary adenomas and intrasellar gangliocytomas associated with different clinical syndromes: acromegaly, amenorrhea-galactorrhea, Cushing's disease and isolated tumoral syndrome. Acta Neuropathol 77:320–328
Miller DC, Koslow M, Budzilovich GN, Burstein DE (1990) Synaptophysin: a sensitive and specific marker for ganglion cells in central nervous system neoplasms. Hum Pathol 21:93–98
Nolan JA, Trojanowski JQ, Hogue-Angeletti R (1985) Neurons and neuroendocrine cells contain chromogranin: detection of the molecule in normal bovine tissues by immunochemical and immunohistochemical methods. J Histochem Cytochem 33:791–798
Oberc-Greenwood MA, McKeever PE, Kornblith PL, Smith BH (1984) A human ganglioglioma containing paired helical filaments. Hum Pathol 15:834–838
O'Connor DT, Frigon RP (1984) Chromogranin A, the major catecholamine storage vesicle soluble protein. Multiple size forms, subcellular storage, and regional distribution in chromaffin and nervous tissue elucidated by radioimmunoassay. J Biol Chem 259:3237–3247
Richmond JG, Cunningham DL, Fuste FG, Erickson CC (1966) Ganglioglioma of the brain stem. Am J Clin Pathol 45:692–696
Rubinstein LJ, Herman MM (1972) A light and electron microscopic study of a temporal-lobe ganglioglioma. J Neurol Sci 16:27–48
Russell DS, Rubinstein LJ (1962) Ganglioglioma: a case with long history and malignant evolution. J Neuropathol Exp Neurol 21:185–193
Russell DS, Rubinstein LJ (1989) Ganglioneuromas (gangliocytomas) and ganglioglioma. In: Pathology of tumours of the nervous system, 5th edn. Edward Arnold, London, pp 289–306
Sano T, Saito H, Yamasaki R, Hosoi E, Kameyama K, Saito S, Hirose T, Hizawa K (1986) Production and secretion of immunoreactive growth hormone-releasing factor by pheochromocytomas. Cancer 57:1788–1793
Scheithauer BW, Bruner JM (1987) The ultrastructural spectrum of astrocytic neoplasms. Ultrastruct Pathol 11:535–581
Takahashi H, Ikuta F, Tsuchida T, Tanaka R (1987) Ultrastructural alterations of neuronal cells in a brain stem ganglioglioma. Acta Neuropathol (Berl) 74:307–312
Takahashi H, Wakabayashi K, Kawai K, Ikuta F, Tanaka R, Takeda N, Washiyama K (1989) Neuroendocrine markers in central nervous system neuronal tumors (gangliocytoma and ganglioglioma). Acta Neuropathol 77:237–243
Wilson BS, Lloyd RV (1984) Detection of chromogranin in neuroendocrine cells with a monoclonal antibody. Am J Pathol 115:458–468
Yamada S, Stefaneanu L, Kovacs K, Aiba T, Shishiba Y, Hara M (1990) Intrasellar gangliocytoma with multiple immunoreactivities. Endocr Pathol 1:58–63
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hirose, T., Kannuki, S., Nishida, K. et al. Anaplastic ganglioglioma of the brain stem demonstrating active neurosecretory features of neoplastic neuronal cells. Acta Neuropathol 83, 365–370 (1992). https://doi.org/10.1007/BF00713527
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00713527