Immunofluoroscopic investigation of extravasation of serum proteins in human brain tumours and adjacent structures.

Forty-seven neurosurgical human specimens taken from malignant gliomas and peritumoural brain structures were investigated for extravasation of serum proteins. Serum proteins were visualized microscopically in paraffin-embedded material using a double layer immunofluorescence technique. Proteins accumulated in the tumour and in the adjacent peritumoural white matter, and were mainly located extracellularly. Intracellular uptake was observed in some but not all tumour cells, in reactive astrocytes and, occasionally, in oligodendrocytes and neurons. Diffuse infiltration of products was present in necrotic, cystic and haemorrhagic regions. The distribution of extravasated proteins corresponded precisely to that previously observed in transplanted tumours in cats (Hossmann et al. 1979), suggesting that the pathophysiology of human tumour oedema is similar to that of the experimental material. Since all patients were operated without corticosteroid therapy, the present results can be used as a reference for forthcoming studies on the effect of corticosteroids on peritumorous oedema.