Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
Neuropathology. 2018 Apr;38(2):154-158. doi: 10.1111/neup.12410. Epub 2017 Aug 25.
Although an increasing number of cases of temporal lobe epilepsy (TLE) with ipsilateral amygdala enlargement (AE) have been reported, there are few pathological reports, and no clear consensus has been established. Oligodendroglia or oligodendroglia-like cells (OLCs) have recently attracted attention in epilepsy studies. Here, we report the clinical and pathological findings of a 40-year-old male TLE patient with AE and hippocampal sclerosis, in whom histopathological study demonstrated remarkable clustering of OLCs around the uncus. The patient began to have refractory seizures at the age of 14, and preoperative MRI revealed left amygdala enlargement and left hippocampal atrophy. Other examinations were consistent with left mesial temporal epileptogenicity. He underwent surgical resection and achieved seizure freedom. Histopathological study of the amygdala showed swollen neurons with relatively large bodies and thick neurites, accompanied by vacuolar degeneration in the background. Additionally, there were marked clusters of OLCs with round nuclei and densely stained chromatin around the uncus. The OLCs were Olig2-positive. In the hippocampus, severe cell loss in CA1 and granule cell dispersion in the dentate gyrus were found. These findings may provide some insights for further pathological investigations of TLE with non-neoplastic AE.
尽管越来越多的颞叶癫痫（TLE）伴同侧杏仁核增大（AE）的病例被报道，但很少有病理学报告，也没有明确的共识。少突胶质细胞或少突胶质样细胞（OLC）在癫痫研究中最近引起了关注。在这里，我们报告了一例 40 岁男性 TLE 伴 AE 和海马硬化患者的临床和病理发现，其组织病理学研究显示在钩回周围 OLC 明显聚集。该患者 14 岁开始出现难治性癫痫，术前 MRI 显示左侧杏仁核增大和左侧海马萎缩。其他检查与左侧内侧颞叶致痫性一致。他接受了手术切除并实现了无癫痫发作。对杏仁核的组织病理学研究显示神经元肿胀，细胞体相对较大，轴突较厚，背景中伴有空泡变性。此外，在钩回周围有明显的 OLC 簇，细胞核呈圆形，染色质致密。这些 OLC 为 Olig2 阳性。在海马中，发现 CA1 严重细胞丢失和齿状回颗粒细胞弥散。这些发现可能为进一步研究非肿瘤性 AE 的 TLE 提供一些病理学见解。
