Symptomatic intraventricular xanthogranulomas.

This article reviews symptomatic intraventricular xanthogranulomas, based on a case presentation. Bilateral xanthogranulomas of the choroid plexus were removed surgically from the lateral ventricles of a 12-year-old boy. At 9 years of age, he had evidence of increased intracranial pressure and was hospitalized. Dense enhancing masses were detected in computerized tomogram (CT) brain scan. The lesions were in the region of trigones with extension into the temporal horns and into the right occipital horn. The masses were brightly yellow and greasy. They measured 8.5 x 5.5 x 3.5 cm and 10 x 6.5 x 4.5 cm, respectively, and proved to be xanthogranulomas. Review of 35 reported symptomatic intraventricular xanthogranulomas revealed 11 lesions in the lateral ventricles in which six of them were bilateral. Twenty-two lesions were in the third ventricle, and two lesions were in the fourth ventricle. The lesion shows no significant sexual predilection. The patients’ average age is 37.6 years for males, 32.4 years for females, and 34.3 years for both sexes. The size of symptomatic lesions ranged from 1 to 3 cm in diameter but a few were large, up to 8 to 10 cm. The origin of foamy (xanthoma) cells in the xanthogranulomas arising in the choroid plexus is thought to be multicentric including the choroidal epithelium and stromal arachnoidal cells that have undergone xanthomatous changes. Increased intracranial pressure is the significant clinical feature of the intraventricular xanthogranulomas as in other mass lesions within the skull. Surgical extirpation is the treatment of choice if the lesion is accessible and the patient’s general condition is suitable.

Martin George Netsky: teacher in medical school

Martin George Netsky, a teacher in the Medical School, was interested in neurology and pathology especially neuropathology and medical education. He helped to develop medical education at Chiang Mai Medical School, and neuropathology and immunohistochemistry at Chulalongkorn Medical School. For this, Dr Netsky arranged for Thai neuropathologists and an immunohistochemist to be trained in the United States. These persons, upon their return, established satisfactory services, teaching and research in neuropathology and immunohistochemistry. The immunohistochemistry was first utilized in neuropathology only but later was put to service in anatomic pathology by the Department of Pathology. Today, immunohistochemical laboratories have been set up in several places in Thailand.

Intra-operative diagnosis in surgical neuropathology: a study of 120 cases with reference to squash cytology.

OBJECTIVE: To present results of intra-operative consultation in surgical neuropathology and discuss the diagnostic guideline for squash cytology. MATERIAL AND METHOD: The intra-operative pathological diagnosis of 120 neurosurgical specimens was compared with the final histologic diagnosis. Squash preparation was used solely in 83 cases, frozen sections alone in 3 cases, and both techniques in the remaining. An algorithm for cytologic diagnosis was described. RESULTS: The intra-operative pathological diagnoses in neurosurgery were completely (83%) and partially (13%) correlated with the final results. CONCLUSIONS: Intra-operative diagnosis in surgical neuropathology is reliable. Squash cytology is highly recommended as an alternative approach.