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Your search keyword '"Rodríguez Villagra, Odir"' showing total 2 results
Start Over Author "Rodríguez Villagra, Odir" Topic multiple sclerosis
2 results on '"Rodríguez Villagra, Odir"'

1. Diagnostic red flags: steroid-treated malignant CNS lymphoma mimicking autoimmune inflammatory demyelination.

Author

Barrantes-Freer A, Engel AS, Rodríguez-Villagra OA, Winkler A, Bergmann M, Mawrin C, Kuempfel T, Pellkofer H, Metz I, Bleckmann A, Hernández-Durán S, Schippling S, Rushing EJ, Frank S, Glatzel M, Matschke J, Hartmann C, Reifenberger G, Müller W, Schildhaus HU, Brück W, and Stadelmann C

Subjects
Adrenal Cortex Hormones therapeutic use, Aged, Antineoplastic Agents therapeutic use, Apoptosis, Biopsy, Central Nervous System Neoplasms drug therapy, Cohort Studies, Diagnosis, Differential, Female, Humans, Immunohistochemistry, Inflammation pathology, Lymphoma drug therapy, Male, Middle Aged, Myelin Sheath pathology, T-Lymphocytes pathology, Central Nervous System Neoplasms diagnosis, Central Nervous System Neoplasms pathology, Lymphoma diagnosis, Lymphoma pathology, Multiple Sclerosis diagnosis, Multiple Sclerosis pathology
Abstract

The presence of inflammation and demyelination in a central nervous system (CNS) biopsy points towards a limited, yet heterogeneous group of pathologies, of which multiple sclerosis (MS) represents one of the principal considerations. Inflammatory demyelination has also been reported in patients with clinically suspected primary central nervous system lymphoma (PCNSL), especially when steroids had been administered prior to biopsy acquisition. The histopathological changes induced by corticosteroid treatment can range from mild reduction to complete disappearance of lymphoma cells. It has been proposed that in the absence of neoplastic B cells, these biopsies are indistinguishable from MS, yet despite the clinical relevance, no histological studies have specifically compared the two entities. In this work, we analyzed CNS biopsies from eight patients with inflammatory demyelination in whom PCNSL was later histologically confirmed, and compared them with nine well defined early active multiple sclerosis lesions. In the patients with steroid-treated PCNSL (ST-PCNSL) the interval between first and second biopsy ranged from 3 to 32 weeks; all of the patients had received corticosteroids before the first, but not the second biopsy. ST-PCNSL patients were older than MS patients (mean age: ST-PCNSL: 62 ± 4 years, MS: 30 ± 2 years), and histological analysis revealed numerous apoptoses, patchy and incomplete rather than confluent and complete demyelination and a fuzzy lesion edge. The loss of Luxol fast blue histochemistry was more profound than that of myelin proteins in immunohistochemistry, and T cell infiltration in ST-PCNSL exceeded that in MS by around fivefold (P = 0.005). Our data indicate that in the presence of extensive inflammation and incomplete, inhomogeneous demyelination, the neuropathologist should refrain from primarily considering autoimmune inflammatory demyelination and, even in the absence of lymphoma cells, instigate close clinical follow-up of the patient to detect recurrent lymphoma., (© 2017 International Society of Neuropathology.)

Published
2018
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2. Diagnostic red flags: steroid-treated malignant CNS lymphoma mimicking autoimmune inflammatory demyelination

Author

Barrantes-Freer, Alonso, Engel, Aylin Sophie, Rodríguez-Villagra, Odir Antonio, Winkler, Anne, Bergmann, Markus, Mawrin, Christian, Kuempfel, Tania, Pellkofer, Hannah, Metz, Imke, Bleckmann, Annalen, Hernández-Durán, Silvia, Schippling, Sven, Rushing, Elisabeth J, Frank, Stephan, Glatzel, Markus, Matschke, Jakob, Hartmann, Christian, Reifenberger, Guido, Müller, Wolf, Schildhaus, Hans-Ulrich, Brück, Wolfgang, Stadelmann, Christine, University of Zurich, and Stadelmann, Christine

Subjects
Male, Multiple Sclerosis, Lymphoma, Biopsy, T-Lymphocytes, 10208 Institute of Neuropathology, 610 Medicine & health, Antineoplastic Agents, Apoptosis, Multiplesclerosis, Central Nervous System Neoplasms, Cohort Studies, Diagnosis, Differential, Adrenal Cortex Hormones, hemic and lymphatic diseases, Humans, Corticosteroids, Diffuse large Bcell lymphoma, Myelin Sheath, Research Articles, Aged, Inflammation, 2800 General Neuroscience, Middle Aged, Immunohistochemistry, 10040 Clinic for Neurology, 2734 Pathology and Forensic Medicine, 2728 Neurology (clinical), 570 Life sciences, biology, Female, Demyelination
Abstract

The presence of inflammation and demyelination in a central nervous system (CNS) biopsypoints towards a limited, yet heterogeneous group of pathologies, of which multiple sclerosis(MS) represents one of the principal considerations. Inflammatory demyelination has alsobeen reported in patients with clinically suspected primary central nervous system lymphoma(PCNSL), especially when steroids had been administered prior to biopsy acquisition. Thehistopathological changes induced by corticosteroid treatment can range from mild reductionto complete disappearance of lymphoma cells. It has been proposed that in the absence ofneoplastic B cells, these biopsies are indistinguishable from MS, yet despite the clinicalrelevance, no histological studies have specifically compared the two entities. In this work,we analyzed CNS biopsies from eight patients with inflammatory demyelination in whomPCNSL was later histologically confirmed, and compared them with nine well defined earlyactive multiple sclerosis lesions. In the patients with steroid-treated PCNSL (ST-PCNSL) theinterval between first and second biopsy ranged from 3 to 32 weeks; all of the patients hadreceived corticosteroids before the first, but not the second biopsy. ST-PCNSL patients wereolder than MS patients (mean age: ST-PCNSL: 6264 years, MS: 3062 years), andhistological analysis revealed numerous apoptoses, patchy and incomplete rather thanconfluent and complete demyelination and a fuzzy lesion edge. The loss of Luxol fast bluehistochemistry was more profound than that of myelin proteins in immunohistochemistry,and T cell infiltration in ST-PCNSL exceeded that in MS by around fivefold (P50.005).Our data indicate that in the presence of extensive inflammation and incomplete,inhomogeneous demyelination, the neuropathologist should refrain from primarilyconsidering autoimmune inflammatory demyelination and, even in the absence of lymphomacells, instigate close clinical follow-up of the patient to detect recurrent lymphoma. University of Göttingen/[SFB-TRR 43]//Alemania UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Centro de Investigación en Neurociencias (CIN)

Published
2017

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