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Cerebellar granular layer degeneration in small cell lung cancer: paraneoplastic cerebellopathy or artifact?

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Barcikowska M., Kida E., Joachimowicz E., Siekierzynska A.
Neuropatologia Polska
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1992
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vol. 30
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issue 2
155-163
EN
The aim of our study was to ascertain whether granular cell degeneration represents uniquely an artifiactual or a supravital event in patients with oat cell carcinoma. The material includes 52 cases of small cell lung cancer (SLC). formalin fixed and paraffin embedded representative cerebellar slides were stained routinely (HE, Kluver-Barrera), and some of them served as material for immunohistochemical study. The following antibodies were used? anti-ferritin, anti-GFAP, anti-IgG and anti-C3 complement fraction. Finally 5 cases out of our material could be diagnosed as paraneoplastic cerebellar degeneration (PCD). on the basis of lack of metastases within the CNS and concomitant intensive loss of Purkinje and granule cells. Clinically the cerebellar syndrome was disclosed in 3 cases. In the granular layer prevalence of microglial cell reaction was noted. GFAP-labeled astroglia were not demonstrated in the same intensity. Antisera to the C3 complement fraction showed moderate staining of Purkinje cell cytoplasm and in 4 cases also in granule cell nuclei. The immunopathological changes presently observed and glial cell proliferation could be evidence for a nonartifactual origin of PCD.
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Impact of vascular diseases on the progression of mild cognitive impairment to Alzheimer’s disease

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Nesteruk M., Nesteruk T., Styczyńska M., Barcikowska M.
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EN
Introduction: Mild cognitive impairment does not meet the criteria for the diagnosis of dementia, but reaching this diagnosis raises concern about the future state of a patient due to the possibility of the conversion to Alzheimer’s disease. Although the aetiology of Alzheimer’s disease is neurodegenerative, the impact of vascular diseases is also taken into consideration. The aim of this study was to assess the impact of vascular diseases in patients diagnosed with mild cognitive impairment on the conversion to Alzheimer’s disease. Material and methods: In each of 101 patients with a diagnosis of mild cognitive impairment, a detailed medical history was taken, taking into account: hypertension, ischaemic heart disease, arrhythmias, myocardial infarction, stroke, diabetes as well as thyroid diseases, head injuries, alcohol abuse, smoking, exposure to toxic substances, surgery under general anaesthesia and the family character of dementia. Clinical follow-ups were scheduled after 6, 12 and 24 months. Results: Amongst 101 patients with mild cognitive impairment, 17 (16.8%) converted to Alzheimer’s disease within two years of observation. The analysis of the distribution of independence tests showed that the conversion is significant for two variables: ischaemic heart disease and myocardial infarction.
PL
Wstęp: Łagodne zaburzenia poznawcze nie spełniają kryteriów rozpoznania zespołu otępiennego, jednakże ustalenie tego rozpoznania wzbudza obawę o przyszły stan pacjenta, w związku z zagrożeniem konwersją do choroby Alzheimera. Mimo etiologii zwyrodnieniowej choroby Alzheimera brany pod uwagę jest również wpływ chorób naczyniowych na rozwój tej choroby. Celem pracy była ocena wpływu obciążenia chorobami naczyniowymi u pacjentów ze zdiagnozowanymi łagodnymi zaburzeniami poznawczymi na konwersję do choroby Alzheimera. Materiał i metody: U 101 pacjentów z rozpoznaniem łagodnych zaburzeń poznawczych przeprowadzono szczegółowy wywiad chorobowy, uwzględniający: nadciśnienie tętnicze, chorobę niedokrwienną serca, zaburzenia rytmu serca, zawał serca, udar mózgu, cukrzycę, a ponadto choroby tarczycy, urazy głowy, nadużywanie alkoholu, nikotynizm, kontakt z substancjami toksycznymi, operacje w znieczuleniu ogólnym i rodzinność otępienia. Zaplanowano wizyty kliniczne po 6, 12, 24 miesiącach. Wyniki: Spośród 101 pacjentów z rozpoznaniem łagodnych zaburzeń poznawczych u 17 osób (16,8%) stwierdzono konwersję do choroby Alzheimera w ciągu 2 lat obserwacji. Analiza testów niezależności rozkładów wykazała, że konwersja jest istotna dla dwóch zmiennych: choroby niedokrwiennej serca oraz zawału serca w wywiadzie.
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