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Article

Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images

  • Authors:
    • Ju Hyung Moon
    • Se Hoon Kim
    • Jin‑Kyoung Shim
    • Tae‑Hoon Roh
    • Kyoung Su Sung
    • Ji‑Hyun Lee
    • Junseong Park
    • Junjeong Choi
    • Eui‑Hyun Kim
    • Sun Ho Kim
    • Seok‑Gu Kang
    • Jong Hee Chang
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, Department of Pathology, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, Department of Pharmacy, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Republic of Korea
  • Pages: 837-844
    |
    Published online on: June 16, 2016
       https://doi.org/10.3892/or.2016.4881
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Abstract

During 5-aminolevulinic acid (ALA)-guided glioblastoma multiforme (GBM) surgery, we encountered fluorescence in ventricular walls that lacked enhancement on magnetic resonance (MR) images and were free of macroscopic invasion of tumor cells. However, the meaning of ventricular wall fluorescence during 5-ALA-guided surgery is still unknown. The aim of this study was to investigate the relationship between intraoperative 5-ALA fluorescence and histopathological findings of ventricular walls free of enhancement on MR images. Nineteen patients with newly diagnosed GBM located near the lateral ventricle underwent 5‑ALA fluorescence‑guided surgery. During the surgery, the ventricle wall was opened and investigated with the aid of a surgical microscope equipped with optical filters to examine 5‑ALA fluorescence of the ventricular wall. Twenty‑five ventricular wall tissues that were apparently free of tumor involvement by MR imaging and macroscopic observation were obtained during surgery. Among the 19 cases with brightly fluorescing tumor masses, 11 patients (57.9%) exhibited 5‑ALA‑induced fluorescence in the ventricular wall. Of the 25 ventricular wall samples, 11 exhibited 5‑ALA‑induced fluorescence; upon pathologic examination, tumors were present in 5 samples (45.5%), but the remaining 6 (54.5%) were free of tumor cells. A pathologic examination revealed no tumor cells in the 14 samples that lacked 5‑ALA‑induced fluorescence. Our data suggest the possibility that glioma cells exhibiting 5‑ALA fluorescence are present in the ventricle wall, despite no signs of tumor involvement in MR images. Further investigation of non‑tumor cells from tissues with 5‑ALA fluorescence is needed to understand the nature of this unexpected ventricular wall fluorescence.
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Copy and paste a formatted citation
Spandidos Publications style
Moon JH, Kim SH, Shim JK, Roh TH, Sung KS, Lee JH, Park J, Choi J, Kim EH, Kim SH, Kim SH, et al: Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. Oncol Rep 36: 837-844, 2016.
APA
Moon, J.H., Kim, S.H., Shim, J., Roh, T., Sung, K.S., Lee, J. ... Chang, J.H. (2016). Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. Oncology Reports, 36, 837-844. https://doi.org/10.3892/or.2016.4881
MLA
Moon, J. H., Kim, S. H., Shim, J., Roh, T., Sung, K. S., Lee, J., Park, J., Choi, J., Kim, E., Kim, S. H., Kang, S., Chang, J. H."Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images". Oncology Reports 36.2 (2016): 837-844.
Chicago
Moon, J. H., Kim, S. H., Shim, J., Roh, T., Sung, K. S., Lee, J., Park, J., Choi, J., Kim, E., Kim, S. H., Kang, S., Chang, J. H."Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images". Oncology Reports 36, no. 2 (2016): 837-844. https://doi.org/10.3892/or.2016.4881
Copy and paste a formatted citation
x
Spandidos Publications style
Moon JH, Kim SH, Shim JK, Roh TH, Sung KS, Lee JH, Park J, Choi J, Kim EH, Kim SH, Kim SH, et al: Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. Oncol Rep 36: 837-844, 2016.
APA
Moon, J.H., Kim, S.H., Shim, J., Roh, T., Sung, K.S., Lee, J. ... Chang, J.H. (2016). Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images. Oncology Reports, 36, 837-844. https://doi.org/10.3892/or.2016.4881
MLA
Moon, J. H., Kim, S. H., Shim, J., Roh, T., Sung, K. S., Lee, J., Park, J., Choi, J., Kim, E., Kim, S. H., Kang, S., Chang, J. H."Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images". Oncology Reports 36.2 (2016): 837-844.
Chicago
Moon, J. H., Kim, S. H., Shim, J., Roh, T., Sung, K. S., Lee, J., Park, J., Choi, J., Kim, E., Kim, S. H., Kang, S., Chang, J. H."Histopathological implications of ventricle wall 5-aminolevulinic acid-induced fluorescence in the absence of tumor involvement on magnetic resonance images". Oncology Reports 36, no. 2 (2016): 837-844. https://doi.org/10.3892/or.2016.4881
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