机译
海马颗粒细胞弥散:无癫痫病史的小儿患者的非特异性发现
摘要:Stereotypically, the human hippocampal GC layer appears to have a compact, neuron-dense histology, with a sharp boundary separating the molecular layer (Fig. b’,c,c’). While studying the cadaveric hippocampal samples from patients with history of epilepsy or seizure, we observed co-existence of compact GC layer and a range of GCD subtypes in the DG (Fig. d-d”, e), as originally reported in hippocampal samples of TLE patients [ ]. These were later classified by Blumcke et al. into different categories of DG granule cell pathology (GCP) [ ]. This classification offered 3 major categories – 1) entire DG appears normal, or non-GCP; 2) Type 1 GCP, characterized by severe cell loss; and 3) Type 2 GCP, that includes at least one DG focus of broadening, clustering or duplication of GC layer [ ]. In our study, we further subdivided Type 2 GCP category broadly into two subtypes. The first is marked by broad, less dense GC layer, often with poorly defined borders with the molecular layer; we refer to this as “disaggregated” GCD (DA). The second subtype has a bilaminar appearance of the GC layer with cell-sparse zone in the center [ , ]; we refer to this as “tram-track” GCD (TT). By studying the H&E-stained hippocampal specimens from patients with seizure history ( = 21), we categorized the morphology of GC layer for each as compact (10/21; 47.62%, subtype equivalent to non-GCP of [ ]), only DA (5/21; 23.81%), only TT (1/21; 4.76%), or both DA and TT (5/21; 23.81%) (Table ). Focal granule cell loss was observed in only 1 seizure case (rigorous morphometric analysis of neuronal density was not performed). As previously reported [ ], we also encountered dispersion and variation in the pattern and thickness of the GC layer at the angles and enfolded regions of both control and seizure-affected hippocampi. However, these areas were excluded from our consideration of “GCD” and also from our quantitative analyses.