Acta Neuropathologica

, Volume 100, Issue 6, pp 635–646 | Cite as

Foamy cells with oligodendroglial phenotype in childhood ataxia with diffuse central nervous system hypomyelination syndrome

  • K. Wong
  • Regina C. Armstrong
  • Kymberly A. Gyure
  • Alan L. Morrison
  • Diana Rodriguez
  • Reuben Matalon
  • Anne B. Johnson
  • Robert Wollmann
  • Enid Gilbert
  • Tuan Q. Le
  • Courtney A. Bradley
  • Kevin Crutchfield
  • Raphael Schiffmann
Regular paper

Abstract

Childhood ataxia with diffuse central nervous system hypomyelination syndrome (CACH) is a recently described leukodystrophy of unknown etiology. To characterize the neuropathological features and gain insight as to the pathogenesis of this disorder, we studied cerebral tissue from six patients with the CACH syndrome. Evaluation of toluidine blue-stained, semithin sections of white matter from CACH patients disclosed unusual cells with “foamy” cytoplasm, small round nuclei and fine chromatin. Electron microscopy (EM) revealed cells in the white matter with abundant cytoplasm containing many mitochondria and loosely clustered, membranous structures, but lacking the lysosomal structures seen in macrophages. Further analysis of tissue sections with antibodies and special stains demonstrated that the abnormal cells with abundant cytoplasm labeled with oligodendroglial markers, but did not react with macrophage or astrocytic markers. Double immunolabeling with macrophage and oligodendroglial markers clearly distinguished macrophages from the “foamy” oligodendroglial cells (FODCs). Proteolipid protein (PLP) mRNA in situ hybridization demonstrated PLP mRNA transcripts in a high proportion of oligodendrocytes in CACH patients compared to control patients, and PLP mRNA transcript signal in cells, morphologically consistent with FODCs. Normal and pathological brain control tissues did not contain FODCs. These neuropathological findings will be useful pathological identifiers of CACH, and may provide clues to the pathogenesis of this disorder.

Key words Childhood ataxia with diffuse central nervous system hypomyelination (CACH syndrome) Leukodystrophy Myelin Oligodendroglia 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • K. Wong
    • 1
  • Regina C. Armstrong
    • 2
  • Kymberly A. Gyure
    • 1
  • Alan L. Morrison
    • 1
  • Diana Rodriguez
    • 3
  • Reuben Matalon
    • 4
  • Anne B. Johnson
    • 5
  • Robert Wollmann
    • 6
  • Enid Gilbert
    • 7
  • Tuan Q. Le
    • 2
  • Courtney A. Bradley
    • 2
  • Kevin Crutchfield
    • 8
  • Raphael Schiffmann
    • 8
  1. 1.Department of Neuropathology at the Armed Forces Institute of Pathology, 16th Street NW, Building 54, Washington DC, 20306-6000, USA e-mail: Wong@AFIP.OSD.MIL Tel.: +1-202-782-1620, Fax: +1-202-782-4099US
  2. 2.Department of Anatomy and Cell Biology at the Uniformed Services University of the Health Sciences, Bethesda, Maryland, USAUS
  3. 3.Sérvice de neuropédiatrie, INSERM U342, Hôpital Saint Vincent de Paul, AP-HP, Paris, FranceVC
  4. 4.University of Texas Medical Center, Galveston, Texas, USAUS
  5. 5.Departments of Pathology and of Neuroscience, Albert Einstein College of Medicine New York, New York, USAUS
  6. 6.Department of Pathology, University of Chicago Hospitals, Chicago, Illinois, USAUS
  7. 7.Department of Pathology at Tampa General Hospital, Tampa, Florida, USAUS
  8. 8.Developmental and Metabolic Neurology Branch of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, Bethesda, Maryland, USAUS

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