Institute of Neuropathology, University Hospital Münster, Münster, Germany.
Amyloidosis Center, Heidelberg University Hospital, Heidelberg, Germany.
Brain Pathol. 2018 Mar;28(2):234-239. doi: 10.1111/bpa.12493. Epub 2017 Mar 13.
Amyloidomas are rare amyloid-containing lesions, which may also occur in the central nervous system. Etiology, pathogenesis and clinical course are poorly understood. To gain more insight into the biology of cerebral amyloidoma, they aimed to characterize its histopathological, molecular and clinical features in a retrospective series of seven patients. FFPE tissue specimens were examined using immunohistochemistry, chromogenic in situ hybridization (CISH) for light chains kappa and lambda as well as an IgH gene clonality analysis. Follow-up information was gathered by reviewing patient records and imaging results. Median age of the three males and four females was 50 years (range: 35-53 years). All cerebral amyloidomas were located supratentorially and were classified as lambda light chain amyloidosis (AL-λ; n = 6) and kappa light chain amyloidosis (AL-κ; n = 1) on immunohistochemistry and CISH. B-cell clonality was confirmed by IgH gene clonality assay in all cases examined. After a median follow-up of 21 months, all patients were alive and showed stable disease. No progression to systemic disease was observed. In conclusion, their data suggest that cerebral amyloidoma is a local disease characterized by B-cell clonality and associated with a stable clinical course.
淀粉样瘤是罕见的含淀粉样物质病变,也可能发生在中枢神经系统。其病因、发病机制和临床病程尚不清楚。为了更深入地了解脑淀粉样瘤的生物学特性,他们旨在通过回顾性系列的 7 名患者,对其组织病理学、分子和临床特征进行描述。使用免疫组织化学、κ 和 λ 轻链的显色原位杂交 (CISH) 以及 IgH 基因克隆性分析对 FFPE 组织标本进行检查。通过回顾患者记录和影像学结果来收集随访信息。3 名男性和 4 名女性的中位年龄为 50 岁(范围:35-53 岁)。所有脑淀粉样瘤均位于幕上,免疫组织化学和 CISH 显示为 λ 轻链淀粉样变性 (AL-λ; n=6) 和 κ 轻链淀粉样变性 (AL-κ; n=1)。所有检查的病例均通过 IgH 基因克隆性检测证实 B 细胞克隆性。中位随访 21 个月后,所有患者均存活且疾病稳定。未观察到向系统性疾病的进展。总之,他们的数据表明,脑淀粉样瘤是一种局部疾病,其特征为 B 细胞克隆性,并与稳定的临床病程相关。