PMC4499620_01
Nuclear staining for Ki-67 antigen (clone MIB1, Dako): MIB-1 proliferative index is greater than 5%.
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fig1
A consecutive pathologic electron microscopy showed an atypical sparsely granulated corticotroph tumour, with an MIB-1 index >5% (Figures 1 and 2), very low activity of O6-methylguanine DNA methyltransferase (MGMT) in tumour cells (Figure 3), and positive receptor SSRT 2A (weak cytoplasmic) reaction.
Ultrastructural features of sparsely granulated corticotroph adenoma (original magnification, 9700x). The cell has well developed Golgi complexes, dilated endoplasmic reticulum, and sparse, variable in shape and electron density secretory granules that measure 200 to 250 nm in diameter. Perinuclear bundles of cytokeratin filaments are absent.
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fig2
A consecutive pathologic electron microscopy showed an atypical sparsely granulated corticotroph tumour, with an MIB-1 index >5% (Figures 1 and 2), very low activity of O6-methylguanine DNA methyltransferase (MGMT) in tumour cells (Figure 3), and positive receptor SSRT 2A (weak cytoplasmic) reaction.
Positive MGMT reaction was observed in endothelial cells and only in single tumor cells. Activity of MGMT in tumor cells was assessed as very low.
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fig3
A consecutive pathologic electron microscopy showed an atypical sparsely granulated corticotroph tumour, with an MIB-1 index >5% (Figures 1 and 2), very low activity of O6-methylguanine DNA methyltransferase (MGMT) in tumour cells (Figure 3), and positive receptor SSRT 2A (weak cytoplasmic) reaction.
The assessment of tumour size (A, B) based on the MRI picture. The tumour volume (C) was measured using the computer program OsiriX. Frontal (A, C) and sagittal (B) scans.
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fig4
MRI scans performed before TMZ therapy are presented in Figure 4. Initial maximal tumour dimensions were 3.441 x 3.916 cm in frontal (Figure 4(a): (A)) and 5.132 x 3.332 cm (Figure 4(a): (B)) in sagittal images and its volume was 16.2 mL (Figure 4(a): (C)). MRI scans showed a further reduction of tumour size (3.554 x 2.466 cm) (Figure 4(b): (A)) and 4.787 x 2.345 cm (Figure 4(b): (B)) in frontal and sagittal images, respectively, and a reduction of volume of about 1,21 mL (Figure 4(b): (C)).