Cell-in-cell phenomena of intracellular neutrophils in a recurrent pleomorphic xanthoastrocytoma

Authors

  • Gianna M. Fote UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA; UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA https://orcid.org/0000-0002-1854-7894
  • Kamran Urgun UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA
  • Jordan Davies UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA
  • Alexander S. Himstead UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA
  • Kevin Gramajo-Aponte UC Irvine School of Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA
  • Alexander Lopez UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA
  • Frank P.K. Hsu UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA
  • William H. Yong UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA

DOI:

https://doi.org/10.17879/freeneuropathology-2024-5341

Keywords:

Glioma, Brain tumor, Pleomorphic xanthoastrocytoma, Phagocytosis, Case report, Emperipolesis, Cell-in-cell

Abstract

We describe a case of a young patient with a recurrent pleomorphic xanthoastrocytoma (PXA) showing unusual cell-in-cell (CiC) phenomena. We observed mostly viable but also necrotic neutrophils engulfed within tumor cells. The recurrent tumor was immunopositive for BRAFV600E mutant protein and showed CDKN2 homozygous deletions typical of PXA. Both genetic alterations were also reported in the original primary tumor. Unlike the original tumor that was GFAP and Olig-2 immunopositive, the recurrent neoplasm was largely negative for GFAP and Olig-2 suggesting dedifferentiation. The large malignant cells that contained the neutrophils were negative for histiocytic and lymphohematopoietic markers. Whereas CDKN2 homozygous deletion is common in PXA, its presence is rare in histiocytic neoplasms. Both reactive astrocytes and glial neoplasms very rarely may engulf neutrophils in a process resembling emperipolesis or cellular cannibalism. Future work may clarify which type of CiC pathway is involved.

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Author Biographies

Gianna M. Fote, UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA; UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA

Gianna Fote, MD/PhD is a resident physician in the Department of Neurosurgery, University of California, Irvine.

Kamran Urgun, UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA

Resident physician, Department of Pathology and Laboratory Medicine, University of California, Irvine

Jordan Davies, UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA

Resident physician, Department of Neurosurgery, University of California, Irvine

Alexander S. Himstead, UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA

Resident phsician, Department of Neurosurgery, University of California, Irvine

Kevin Gramajo-Aponte, UC Irvine School of Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA

Medical student, University of California, Irvine School of Medicine

Alexander Lopez, UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA

Resident physician, Department of Neurosurgery, University of California, Irvine

Frank P.K. Hsu, UC Irvine School of Medicine, Department of Neurosurgery, University of California, 200 South Manchester Ave, Orange, CA 92868, USA

Dr. Frank P.K. Hsu is Professor and Chair of he Department of Neurological Surgery, UCI School of Medicine, Director of UCI Health Neurosurgery Services, Professor of the Department of Biological Engineering, UCI Henry Samueli School of Engineering, and Professor of the Department of Otolaryngology /Head and Neck Surgery, UCI School of Medicine. Before coming to UCI Medical Center, he served as director of functional, cerebrovascular and skull base surgery at Loma Linda University Medical Center in Loma Linda, Calif..

William H. Yong, UC Irvine School of Medicine, Department of Pathology and Laboratory Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA

Dr. Yong serves as Vice-Chair of Integration and Strategic Initiatives, Chief of Neuropathology, Director, Neuropathology Fellowship, and Clinical Professor of Pathology and Laboratory Medicine, Department of Pathology and Laboratory Medicine at the University of California Irvine School of Medicine. 

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Published

2024-08-08

How to Cite

Fote, G. M., Urgun, K., Davies, J., Himstead, A. S., Gramajo-Aponte, K., Lopez, A., Hsu, F. P., & Yong, W. H. (2024). Cell-in-cell phenomena of intracellular neutrophils in a recurrent pleomorphic xanthoastrocytoma. Free Neuropathology, 5, 17. https://doi.org/10.17879/freeneuropathology-2024-5341

Issue

Vol. 5 (2024)

Section

Letters

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Copyright (c) 2024 Gianna M. Fote, Kamran Urgun, Jordan Davies, Alexander S. Himstead, Kevin Gramajo-Aponte, Alexander Lopez; Frank P.K. Hsu; William H. Yong

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Papers are published open access under the Creative Commons BY 4.0 license. This license lets others distribute, remix, adapt, and build upon your work, even commercially, as long as they credit you for the original creation. Data included in the article are made available under the CC0 1.0 Public Domain Dedication waiver, unless otherwise stated, meaning that all copyrights are waived.