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NEUROLOGY 1988;38:413
© 1988 American Academy of Neurology

Meningeal carcinomatosis

Origin of local IgG production in the CSF

Hayo Ihnken Schipper, MD, Attila Bardosi, MD, Claus Jacobi, MD and Klaus Felgenhauer, MD

From the Departments of Neurology (Drs. Schipper, Jacobi, and Felgenhauer) and Neuropathology (Dr. Bardosi), University of Goettingen, Germany.

We found that eight of 22 patients with meningeal carcinomatosis from different primary tumors produced local IgG in the CSF, as indicated by elevated IgG index and/or oligoclonal IgG subfractions. Local IgG production, when present, appears in an early stage of the leptomeningeal manifestation and remains detectable over extended observation periods. In autopsied cases with local IgG production, we observed numerous perivascular round-cell infiltrates containing plasma cells and large lymphocytes within the leptomeningeal tumor tissue. After incubation with immunoperoxidase, only these cells showed IgG-specific staining, indicating the site of local IgG production.

Address correspondence and reprint requests to Priv.-Doz. Dr. Schipper, Neurologische Universitaets-Klinik, Robert-Koch-Strasse 40, D-3400 Goettingen, FRG.

Received May 4, 1987. Accepted for publication in final form June 29, 1987.




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