HOME HELP FEEDBACK SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Miscellaneous lesions Related ASH-SAP Chapter Related Image Bank Image Sets Social Bookmarking                   What's this?

Neuroblastoma Ganglion Cell Differentiation Following Chemotherapy

View larger version (165K): [in this window] [in a new window]   Figure 1. . Patient is a two year old African-American female with a diagnosis of Stage IV neuroblastoma. The image shown is a low power view of her diagnostic bone marrow biopsy. At this magnification there appears to be a homogeneous infiltrate of small "blue" cells without evidence of normal hematopoietic elements. In areas cells appear to be forming distinct groupings with separations from each other, (H&E 10x).

View larger version (177K): [in this window] [in a new window]   Figure 2. The monotony of the cellular infiltrate is more apparent in this view as well as the streaking of the group of cells. Rosette formation (Homer Wright rosettes) is suggested. (H&E 20x)

View larger version (176K): [in this window] [in a new window]   Figure 3. In this view the cells appear to be small with minimal cytoplasm. The nuclei show variation in size, nuclear chromatin pattern and some contain nucleoli. A few plasma cells can also be seen. (H&E 40x)

View larger version (179K): [in this window] [in a new window]   Figure 4. A small area of normal hematopoietic elements (erythroid and myeloid precursors) can be seen circumscribed by the malignant cellular infiltrate. Note that the infiltrate has replaced the normal paratrabecular site of early myeloid element formation. (H&E 40x)

View larger version (173K): [in this window] [in a new window]   Figure 5. In this view of an adjacent area of marrow there are fewer cellular elements with the suggestion of fibrosis being present. The fibrosis was confirmed with a reticulin stain. (H&E 20x)

View larger version (148K): [in this window] [in a new window]   Figure 6. The biopsy image shown in this view is a post-chemotherapy images following cyclophosphamide and topotecan administration. Normal hematopoietic elements are readily identified even in this relatively low power view. Of interest there is a well circumscribed lesion in the top center of the image. (H&E 10x)

View larger version (161K): [in this window] [in a new window]   Figure 7. At a higher magnification the lesion appears paler than the surrounding hematopoietic elements and at first suggests the presence of a granulomatous lesion. (H&E 20x)

View larger version (176K): [in this window] [in a new window]   Figure 8. The cells in the lesion are much larger than the original neuroblastoma cells. In addition the cells have abundant cytoplasm and large vesicular nuclei. Multiple small nucleoli can be seen in some cells while others have large single nucleolus. These cells are morphologically consistent with ganglion cells and suggest differentiation of the neuroblastoma following chemotherapy. (H&E 40x)

View larger version (165K): [in this window] [in a new window]   Figure 9. A similar process is suggested in this image from another section of the biopsy. The cellular infiltrate on the right third of the image is distinct from the normal hematopoietic elements present and appears to have the same streaking appearance as the original tumor. (H&E 20x)

View larger version (180K): [in this window] [in a new window]   Figure 10. At higher magnification it is apparent that this infiltrate has a cellular composition of both small and large cells consistent with residual neuroblastoma and tumor differentiation to ganglion-like cells. (H&E 40x)

View larger version (161K): [in this window] [in a new window]   Figure 11. A chromagranin immunohistochemicalstain was positive in the large cells shown in this image. (H&E 10x)

View larger version (189K): [in this window] [in a new window]   Figure 12. At a higher magnification, the chromagranin immunostain outlines the abundant cytoplasm of these large cells. These results confirmed the differentiation of the original neuroblastoma infiltrate following chemotherapy. (H&E 40x)

CiteULike

Connotea

Del.icio.us

Digg

Reddit

Technorati

Related Image Bank Image Sets

Neuroblastoma

Peter Maslak
ASH Image Bank 2002 2002: 100412. [Full Text]

Neuroblastoma - pleural fluid

Peter Maslak and Lisa Southern
ASH Image Bank 2002 2002: 100494. [Full Text]

Metastatic Neuroblastoma

John Lazarchick and Hach Turyan
ASH Image Bank 2004 2004: 100987. [Full Text]

Rhabdomyosarcoma

Peter Maslak
ASH Image Bank 2004 2004: 101217. [Full Text]

Retinoblastoma

Peter Maslak
ASH Image Bank 2005 2005: 101322. [Full Text]

Ewing’s sarcoma

Peter Maslak
ASH Image Bank 2008 2008: 800012. [Full Text]

Related ASH-SAP Chapter:

This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Miscellaneous lesions Related ASH-SAP Chapter Related Image Bank Image Sets Social Bookmarking                   What's this?