Different vascular patterns of medulloblastoma and supratentorial primitive neuroectodermal tumors

Abstract

Astrocytoma vasculature patterns differ according to histological grade of malignancy with glioblastoma multiforme (WHO grade IV) showing most extensive endothelial proliferation. Here, we determined whether the vascular patterns of medulloblastoma and supratentorial primitive neuroectodermal tumors (PNETs), which can be hardly distinguished histopathologically, differ. We evaluated the spatial organization of vessels in medulloblastomas and PNETs using antibodies to von Willebrand factor (vWF) and CD34. Medulloblastoma capillaries showed slight endothelial cell hyperplasia. Microvessels sprouted from the capillaries and formed glomeruloid clusters. There were areas with chains of unopposed endothelial cells (3-10 cells). Supratentorial PNETs had highly branched capillaries with extensive endothelial cell hyperplasia. Glomeruloid arrays of microvessels extended from the capillaries. Small fragments of endothelial tubes were scattered throughout the tumor. Therefore, medulloblastomas and supratentorial PNETs showed different spatial organization of tumor vessels which can be used for differentiation of each tumor entity. These vascular patterns may reflect different tumor derived angiogenic stimuli.

Diffusion-weighted magnetic resonance imaging of treatment-associated changes in recurrent and residual medulloblastoma: preliminary observations in three children

“…In a radiopathologic study of nine recurrent medulloblastomas, there was even heterogeneity of contrast uptake noted between recurrent tumor and metastases (14). The exact sensitivity of DWI in non-enhancing medulloblastoma needs to be established, but the observed advantage over CE T1 in this and previous reported cases (4) may be best explained by early high cellularity, even before leaky tumor vessels develop (6).…”

Classification of brain tumor type and grade using MRI texture and shape in a machine learning scheme

“…Other data based on microscopy imaging or histopathological exams could also be included to increase accuracy in predictions. For example nuclear features extracted from segmented nuclei [42] or blood vessel patterns [43] can assist brain astrocytomas malignancy grading, and the spatial organization of tumor vessels can be indicative for differentiation between medulloblastomas and supratentorial PNETs [44]. Voxel-wise histopathological parameters that reflect proliferation and protein synthesis or PET imaging could also be used, if available, in order to extend the current framework to output spatial maps of malignancy (instead of a single grade) providing more reliable differentiation of heterogenous neoplasms.…”

Three-dimensional (3D) reconstruction and quantitative analysis of the microvasculature in medulloblastoma and ependymoma subtypes

“…In another study of 100 intracranial ETs, markers for hypoxia (carbonic anhydrase 9, hypoxia-inducible factor 1 alpha and VEGF) were not related to outcome [18]. In a study of supratentorial primitive neuroectodermal tumours and MBs, the spatial organisation of tumour vessels was described to allow for differentiation between different prognostic subtypes [19].…”

“…The vasculature of mpE, which is a WHO grade I tumour, had a distinct irregular and partly dense pattern. While mpEs are classified together with lgEs and aEs in the category of ETs, their typical histopathology, radiology and genetic characteristics indicate that mpEs form a separate entity [19,20]. Although variation for the vascular parameters was high in MBs, these parameters were generally in the range of normal cerebellar cortex and white matter.…”