Fote Gianna M, Urgun Kamran, Davies Jordan, Himstead Alexander S, Gramajo-Aponte Kevin, Lopez Alexander, Hsu Frank P K, Yong William H
UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA.
UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA.
Free Neuropathol. 2024 Aug 8;5:17. doi: 10.17879/freeneuropathology-2024-5341. eCollection 2024 Jan.
We describe a case of a young patient with a recurrent pleomorphic xanthoastrocytoma (PXA) showing unusual cell-in-cell (CiC) phenomena. We observed mostly viable but also necrotic neutrophils engulfed within tumor cells. The recurrent tumor was immunopositive for BRAFV600E mutant protein and showed CDKN2 homozygous deletions typical of PXA. Both genetic alterations were also reported in the original primary tumor. Unlike the original tumor that was GFAP and Olig-2 immunopositive, the recurrent neoplasm was largely negative for GFAP and Olig-2 suggesting dedifferentiation. The large malignant cells that contained the neutrophils were negative for histiocytic and lymphohematopoietic markers. Whereas CDKN2 homozygous deletion is common in PXA, its presence is rare in histiocytic neoplasms. Both reactive astrocytes and glial neoplasms very rarely may engulf neutrophils in a process resembling emperipolesis or cellular cannibalism. Future work may clarify which type of CiC pathway is involved.
我们描述了一例年轻的复发性多形性黄色星形细胞瘤（PXA）患者，其表现出不寻常的细胞内细胞（CiC）现象。我们观察到大多为存活但也有坏死的中性粒细胞被肿瘤细胞吞噬。复发性肿瘤对BRAFV600E突变蛋白免疫阳性，并显示出PXA典型的CDKN2纯合缺失。这两种基因改变在最初的原发性肿瘤中也有报道。与最初免疫阳性的GFAP和Olig-2的肿瘤不同，复发性肿瘤GFAP和Olig-2大多为阴性，提示去分化。含有中性粒细胞的大的恶性细胞对组织细胞和淋巴造血标志物呈阴性。虽然CDKN2纯合缺失在PXA中很常见，但其在组织细胞肿瘤中很少见。反应性星形胶质细胞和神经胶质瘤都非常罕见地可能在一个类似于血细胞渗出或细胞吞噬的过程中吞噬中性粒细胞。未来的研究可能会阐明涉及哪种类型的CiC途径。
