Gliosarcomas: histological, immunohistochemical, ultrastructural, and tissue culture studies

Thirty-nine cases of gliosarcomas, two initiating as fibrosarcomas, 25 as mixed gliomas and sarcomas, and 12 as anaplastic gliomas with secondary sarcomas, were studied by light microscopy, immunohistochemistry, using GFAP, factor VIII/RAg, and Ulex europaeus I agglutinin (UEA I), electron microscopy and tissue culture. GFAP was found variably positive in the glial areas; F VIII/RAg and UEA I, markers of both normal and neoplastic endothelial cells and their derivatives, were found in vessels of both gliomatous and sarcomatous parts of GS, less intensive in hyperplastic glomeruloid structures and, with decreasing intensity, in adjacent fibrosarcomatous areas, while UEA I, giving stronger reaction than F VIII/RAg, was occasionally demonstrated in sarcomatous cells. In vitro studies confirmed previous data of a separate growth of glial and mesenchymal cells with a divergent migratory speed. Electron microscopy demonstrated the frequent close admixture of glial and mesenchymal tumor cells, which showed the feature of either fibrosarcoma or angiosarcoma. The frequent resemblance of the latter with endothelial cells was supported by the occasional demonstration of Weibel-Palade-like bodies in both vascular endothelial and adjacent sarcomatous cells. These observations confirm the hypothesis that at least part of the sarcomatous components in many GS originate from vascular endothelial proliferation and obviously represent the final stage of a process starting with the endothelial hyperplasia in anaplastic gliomas.