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  #1  
Old 10-08-2012
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Neuro Immunohistochemistry of this Brain Tumor!

38 year old woman has seizures,increased Intracranial pressure and weakness in legs. CNS tumor is suspected and after imaging studies biopsy is done. The biopsy shows whorled pattern of cells seen here:

Immunohistochemistry of this Brain Tumor!-brain-tumor.png
click image to enlarge

which of the following will most likely be positive on immunohistochemistry of tumor?

a) TSH/HCG receptor
b) Estrogen/Progesterone receptor
c) Insulin receptor
d) EDGF receptor
c) Growth Hormone Receptor
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Old 10-08-2012
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will go with a) HCG/TSH receptor

psammoma bodies???

thanks
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Old 10-08-2012
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b) Estrogen/Progesterone receptor
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Old 10-08-2012
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its Meningioma(whorled nests)..My ans. D??Both Epidermal growth receptors and progesterone receptors are present on it..estrogen receptors are thought to be present but virtually indetectable..(googled..waiting for actual answer..
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Old 10-08-2012
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Quote:
Originally Posted by venky2600 View Post
will go with a) HCG/TSH receptor

psammoma bodies???

thanks
thought of changing my answer
blindly went on to A by seeing psammoma bodies(papillary ca. thyroid)

now would go with D) EDGF receptor
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Old 10-08-2012
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Default ER-PR receptors

I think these are whirls of cells present along psammoma bodies.
Thats present in Meningiomas
and Meningiomas are female predominant due to presence of Estrogen receptors.
But
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Old 10-08-2012
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i go with epithelial derived growth factor
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So. this question became kinda hard
Answer is ER/PR receptor,according to robbins and Pathoma.

In pathoma sattar says that it's estrogen positive. He didn't said anything about EDGF. RR patholgy says nothing about it. Robbins says: " Meningiomas often express progesterone receptors and may grow more rapidly during pregnancy". Also "primary glioblastomas often have amplified, mutated epidermal growth factor receptor (EGFR) genes" ( EGFR not mentioned in meningiomas)

i did a little research and found this in only one article:

out of 57 meningiomas:
20% of meningiomas are expressing classical oestrogen receptors (ER)
74% of meningiomas demonstrated the presence of progesterone receptors (PR)
100% of meningiomas were positive for presence of epidermal growth factor receptor (EGFR)


http://www.ncbi.nlm.nih.gov/pubmed/2818349

in fact " Koper et al.12 suggested that the presence of progesterone in the culture medium increases the sensitivity of meningioma cells to mitogenic stimuli with epidermal growth factor and other growth factors, whereas mifepristone (progesterone receptor blocking agent) can counteract the stimulating effects of progesterone. " - Suggestion that progesterone receptor are dominantly expressed.


I think if anyone will get this kind of question on step I has to answer ER/PR receptor. especialy if the patient is premenopausal woman.
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  #9  
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In RR page 594
It says meningioma is predominant in female. Due to estrogen receptor but don't mention anything about EDGF.
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Quote:
Originally Posted by koolkiller88 View Post
In RR page 594
It says meningioma is predominant in female. Due to estrogen receptor but don't mention anything about EDGF.
yes that's what i mean
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thanks for the question I think it was kinda hard..
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