Distinctive distribution of lymphocytes in unruptured and previously untreated brain arteriovenous malformation

Guo Y, Tihan T, Kim H, Hess C, Lawton MT, Young WL, Zhao YL, Su H. Distinctive d

Yi Guo1, Tarik Tihan2, Helen Kim3, Christopher Hes

1 Department of Anaesthesia and Perioperative Care

2014

147-152

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Aim: To test the hypothesis that lymphocyte infiltration in brain arteriovenous malformation (bAVM) is not associated with iron deposition (indicator of micro-hemorrhage). Methods: Sections of unruptured, previously untreated bAVM specimens (n = 19) were stained immunohistochemically for T-lymphocytes (CD3 + ), B-lymphocytes (CD20 + ), plasma cells (CD138 + ) and macrophages (CD68 + ). Iron deposition was assessed by hematoxylin and eosin and Prussian blue stains. Superficial temporal arteries (STA) were used as control. Results: Both T-lymphocytes and macrophages were present in unruptured, previously untreated bAVM specimens, whereas few B cells and plasma cells were detected. Iron deposition was detected in 8 specimens (42%; 95% confidence intervals = 20-67%). The samples with iron deposition tended to have more macrophages than those without (666 ± 313 vs. 478 ± 174 cells/mm 2 ; P = 0.11). T-cells were clustered on the luminal side of the endothelial surface, on the vessel-wall, and in the perivascular regions. There was no correlation between T-lymphocyte load and iron deposition (P = 0.88). No macrophages and lymphocytes were detected in STA controls. Conclusion: T-lymphocytes were present in bAVM specimens. Unlike macrophages, the load and location of T-lymphocytes were not associated with iron deposition, suggesting the possibility of an independent cell-mediated immunological mechanism in bAVM pathogenesis.