| Popis: |
A choroid plexus papilloma (CPP) was discovered in the right lateral ventricle of a 16-month-old girl who presented with signs of increased intracranial pressure following a minor head trauma. The tumor was accompanied by communicating hydrocephalus, which, at surgery, was found not to obstruct the flow of cerebrospinal fluid (CSF). The CSF was cytologically normal. The protein content was 50 mg/100 m/, the sugar content 60 mg/100 m/, and the chloride content 118 mEq/1,000 ml. Under electron microscopy the lining cells were seen to be arranged in an orderly fashion. The cytoplasm contained many mitochondria, granular endoplasmic reticulum, Golgi apparatus, free ribosomes, occasional fine filaments and coated vesicles, large aggregates of dense bodies with granular and lamellar internal structures, and multivesicular bodies. The apical protions of these cells were covered by numerous microvilli, cilia, and basal bodies. Electron microscopy revealed the fine structure of the tumor to be essentially that of normal choroid plexus. Although the tumor appeared to have the potential to be high secretory, there was no evidence of hypersecretion of CSF in our ultrastructural study. Removal of the tumor alone was sufficient to reduce the hydrocephalus after some intervals. Because the volume of the CPP was two to three times that of normal choroid plexus and the dilated ventricle did not decrease in size immediately after surgery, it appears that communicating hydrocephalus with CPP does not result solely from hypersecretion of CSF by tumor cells. Additional causes may be an increase in the total CSF volume as a function of the tumor bulk and malabsorption of CSF due to a high CSF protein content. (Shinkeigeka 28: 604–609, 1988) |
