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Abstract
Eosinophils are one of the polymorphonuclear granulocytes derived from bone marrow stem cells, and they contain many small cytoplasmic granules that stain bright red with eosin or brick-red with Romanowsky staining. Eosinophilic infiltration is also present in various human central nervous system (CNS) diseases such as parasitic infection, transverse myelitis, vasculitis, Langerhans cell histiocytosis, glioblastoma and etc... Due to the morphologic and functional characteristics, the presence of eosinophils in certain lesions may provide useful diagnostic clues in the right clinical setting. Consideration of this finding may facilitate the diagnosis of CNS pathologic lesions, especially in a small specimen such as a stereotactic biopsy.
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Fig. 1.
Organizing hematoma: Low power view shows fresh hemorrhage with organization (A. H-E x 40). High power view shows eosinophilic infiltration into the granulation tissue (B. H-E x 200).
Fig. 2.
Eosinophils in CSF (Papanicolaou stain, x 600). Green granulated cytoplasm with bi-lobed nuclei is characteristic (arrows).
Fig. 3.
A rim-enhancing lesion with edema in the right temporal lobe (A. arrow). Histologic section revealed a fragment of the worm (arrows) and dense fibrosis with a few eosinophilic infiltration (B. H-E x40; inlet. H-E x200).
Fig. 4.
The histologic findings of transverse myelitis. 1) perivascular and parenchymal lymphocytic infiltration with many eosinophils, (A. H-E x 200, B. H-E x 400), 2) degranulation of eosinophils, (B and D. H-E x 400) and 3) reactive gliosis (C. H-E x 400, arrows). In addition, giant cells (D. H-E x 400, arrows), Charcot-Leyden crystal protein (E. H-E x 1000, arrow), and the degeneration of myelin and axons (F. Bielschowsky’s silver x 200) compared to control tissue (G. Bielschowsky’s silver x 200) stain were present in Case 1.
Fig. 5.
The histologic findings of CNS vasculitis, Giant cell arteritis (A. H-E x100 and B. H-E x400) and Churg-Strauss vasculitis (C. H-E x100 and D. H-E x 400). Eosinophilic infiltration is noted (arrows).
Fig. 6.
The histologic findings of Langerhans cell histiocytosis with marked artifacts in CNS. Eosinophilic granules and inflammatory cells are seen in crushed focus (A. H-E x100 and B. H-E x400). Aggregates of cells, which nuclei are eccentrically located and indented (arrow), mixed with eosinophilic granules (arrow head) are noted in rare area (C. H-E x 200 and D. H-E x 400). A cluster of large involuted nuclei show CD1a (E. CD1a x 200) and S-100 (F. S-100 x 100, arrows) immunohistochemical staining positivity.
Fig. 7.
Glioblastoma with eosinophils (A. H-E x40). Adjacent necrotic area, eosinophilic infiltration is noted (B. H-E x400, arrows).
Table 1.
The clinicoradiologic features of 4 cases of transverse myelitis
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